NEW YORK (Reuters Health) - Findings from a small phase I trial suggest that biological lung volume reduction (BLVR) is a safe and potentially effective treatment for patients with advanced emphysema.

With BLVR, biological reagents are instilled in the lungs, during bronchoscopy, that cause remodeling and shrinkage of the damaged emphysematous regions. BLVR could represent a useful alternative to lung volume reduction surgery, which has been shown to provide many benefits, but also carries a significant risk of morbidity and mortality and often involves a prolonged hospital stay.

The feasibility of BLVR has been shown in sheep, but the present study represents the first evaluation of this therapy in humans with advanced emphysema.

As reported in the April issue of Chest, Dr. John Reilly, from Brigham and Women's Hospital in Boston, and colleagues assessed the safety of BLVR in six men, between 58 and 73 years of age, with advanced heterogenous emphysema. BLVR was applied unilaterally at two pulmonary subsegments in three patients and unilaterally at four subsegments in the remaining three.

BLVR was well tolerated and did not result in any serious complications, the investigators report. Moreover, all of the patients were successfully discharged on posttreatment day 1.

Although assessing efficacy was not the main focus of the study, the authors did note a number of benefits with BLVR. Compared with baseline values, BLVR was associated with improvements in mean vital capacity, mean residual volume, mean RV/total lung capacity ratio, mean 6-minute walk distance, and in mean dyspnea score.

Patients who had four subsegments treated generally experienced greater benefits than those who had two subsegments treated, providing evidence of a dose-response relationship.

"If these preliminary data are confirmed by the results of other clinical trials that are in progress, BLVR therapy...could represent a less morbid treatment option for patients who are considered to be appropriate candidates for lung volume reduction," the authors conclude.