Abstract Background LIBERATE remains the only clinical trial providing long-term safety and efficacy data beyond one year after endoscopic lung volume reduction (ELVR) using endobronchial valves (EBV). Following our initial experience with this technique, a randomized trial (REPEAT, NCT06181357) comparing a two-stage EBV-ELVR approach with standard care is ongoing in France. Here, we report the two-year outcomes of patients treated at our center using this two-stage protocol. Objective To assess the long-term durability and safety of the two-stage EBV-ELVR procedure in patients treated at Limoges University Hospital. Methods We conducted a retrospective study including 39 patients who underwent EBV-ELVR following Limoges’ two-stage algorithm, with at least two years of follow-up. Baseline post-bronchodilator pulmonary function showed mean FEV1 32.3 ± 10.3% predicted and residual volume (RV) 232.7 ± 38.5%. The mean target lobe volume was 1635 ± 466 mL. Results Improvements in FEV1 from baseline were sustained up to two years, with mean ± SD changes of 180 ± 207 mL at 3 months, 126 ± 248 mL at 1 year, and 49 ± 258 mL at 2 years. Corresponding responder rates (FEV1 increase ≥ 15%) were 53.8%, 46.1%, and 41.0%, respectively. The incidence of respiratory adverse events (AEs) and serious adverse events (SAEs) during years 1-2 was comparable or lower than during the first year. The most frequent SAEs beyond year 1 were COPD exacerbations (n = 5, 12.8%), pneumonia (n = 2, 5.1%), and respiratory failure (n = 1, 2.5%). No pneumothorax was reported after the first year. Conclusion The two-stage EBV-ELVR approach provided sustained improvements in lung function over at least two years, with an acceptable safety profile comparable to that reported in LIBERATE. Although no control group was included, the maintenance of FEV1 improvement over time suggests a lasting physiological benefit, despite the expected decline in lung function in patients with severe emphysema receiving optimal medical therapy. Keywords: Emphysema, 2-stage Endoscopic Lung Volume Reduction, Endobronchial valves, Long term outcomes This abstract is funded by: None
Egenod et al. (Fri,) studied this question.