title: Design of the exhale airway stents for emphysema (EASE) trial: an endoscopic procedure for reducing hyperinflation.
abstract: BACKGROUND
  Airway Bypass is a catheter-based, bronchoscopic procedure in which new passageways are created that bypass the collapsed airways, enabling trapped air to exit the lungs. The Exhale Airway Stents for Emphysema (EASE) Trial was designed to investigate whether Exhale® Drug-Eluting Stents, placed in new passageways in the lungs, can improve pulmonary function and reduce breathlessness in severely hyperinflated, homogeneous emphysema patients (NCT00391612).
  
  
  METHODS
  The multi-center, randomized, double-blind, sham-controlled trial design was posted on http://www.clinicaltrials.gov in October 2006. Because Bayesian statistics are used for the analysis, the proposed enrollment ranged from 225 up to 450 subjects at up to 45 institutions. Inclusion criteria are: high resolution CT scan with evidence of homogeneous emphysema, post-bronchodilator pulmonary function tests showing: a ratio of FEV1/FVC < 70%, FEV1 ≤ 50% of predicted or FEV1 < 1 liter, RV/TLC ≥ 0.65 at screening, marked dyspnea score ≥ 2 on the modified Medical Research Council scale of 0-4, a smoking history of at least 20 pack years and stopped smoking for at least 8 weeks prior to enrollment. Following 16 to 20 supervised pulmonary rehabilitation sessions, subjects were randomized 2:1 to receive either a treatment (Exhale® Drug-Eluting Stent) or a sham bronchoscopy. A responder analysis will evaluate the co-primary endpoints of an FVC improvement ≥ 12% of the patient baseline value and modified Medical Research Council dyspnea scale improvement (reduction) ≥ 1 point at the 6-month follow-up visit.
  
  
  CONCLUSIONS
  If through the EASE Trial, Airway Bypass is shown to improve pulmonary function and reduce dyspnea while demonstrating an acceptable safety profile, then homogeneous patients will have a minimally invasive treatment option with meaningful clinical benefit.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00391612.
authors.affiliation: Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. pallav.shah@ic.ac.uk
authors.forename: Pallav L
authors.initials: PL
authors.lastname: Shah
authors.forename: Dirk-Jan
authors.initials: DJ
authors.lastname: Slebos
authors.forename: Paulo F G
authors.initials: PF
authors.lastname: Cardoso
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Cetti
authors.forename: Gerhard W
authors.initials: GW
authors.lastname: Sybrecht
authors.forename: Joel D
authors.initials: JD
authors.lastname: Cooper
mesh_terms: D000328:Adult; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods*; D002985:Clinical Protocols; D004311:Double-Blind Method; D054855:Drug-Eluting Stents; D004417:Dyspnea / Q000628:therapy; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D018579:Patient Selection; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
chemical_list: D017239:Paclitaxel