A new way to deal with emphysema

Rhode Island Hospital is one of the first testing sites for a new treatment for emphysema that requires inserting fingertip-sized umbrella-shaped devices into the airways in the lungs to redirect airflow away from damaged areas and into healthier areas.
The desired result is to improve patients’ health by making the lungs more efficient, said Dr. Muhanned A. Abu-Hijleh, a pulmonary physician and principal investigator for the federally approved clinical test of the device, called an IBV Valve, at Rhode Island Hospital.
Spiration Inc., the Washington-based developer and manufacturer of the valve, chose the hospital as one of the first testing sites because of its “excellent reputation with pulmonary care,” said Lauri DeVore, director of market research and project management at Spiration.
The hospital, De Vore noted, has experience treating chronic obstructive pulmonary disease.
That specialization is what drew Abu-Hijleh to Rhode Island Hospital as well.
Abu-Hijleh completed a three-year pulmonary and critical care fellowship through Brown University’s medical school in 2002 before joining the staff. Prior to the fellowship he completed his residency at Memorial Hospital of Rhode Island, where he specialized in internal medicine.
Abu-Hijleh said in addition to completing Spiration’s clinical trial for the new treatment, the hospital is also creating an interventional pulmonology program focusing on minimally invasive procedures for COPD patients. And he thinks that contributed to Spiration’s decision to choose Rhode Island Hospital.
It is important to find new treatments for emphysema, Abu-Hijleh said, because the available treatments do little more than make patients feel more comfortable.
“The available treatments are mostly palliative,” he said. “It doesn’t change the outcomes for those people.”
Treatments include pulmonary physical therapy, inhaled steroids and oxygen, brochodilators and more aggressive treatments such as lung reduction and lung transplants.
The new treatment requires using a minimally invasive procedure called a bronchoscopy, which involves inserting a flexible tube through the nose or mouth, to insert the IBV Valves into the airways of the lungs.
“The idea behind the new treatment is to try and achieve some meaningful outcomes in the management of patients, but by doing a minimally invasive procedure,” Abu-Hijleh said.
Spiration anticipates enrolling 40 sites for the clinical test and 450 patients in total. There are currently 19 sites participating in the clinical trial.
Abu-Hijleh said it is too early to discuss the number of patients enrolled at Rhode Island Hospital, but he is looking for people age 40 to 74 with severe emphysema.
The IBV Valve trial is one of 913 clinical studies underway at Rhode Island Hospital, said Nancy Cawley, spokeswoman for the hospital. Many studies are funded by grants. The hospital ranks 15th among independent hospitals that receive funding from the National Institutes of Health.
Abu-Hijleh said clinical trials such as the IBV Valve trial are important for the hospital because they build the hospital’s reputation in research and in the application of new treatments.
“If it proves to be a successful treatment for emphysema, [we] would be recognized as a place of excellence for this treatment,” he said.
And being recognized as a place of excellence for the treatment benefits the hospital from a financial standpoint because it then can attract companies and patients from other states to seek treatment or want to become involved, he said.
“Obviously, this is not why we’re doing the treatment,” Ab-Hijley said. “But it does contribute.”
COPD, which refers to two main lung diseases, namely chronic bronchitis and emphysema, is the fourth leading cause of death in the United States. It affects close to 3 million people.
“Without being involved in clinical trials such as this, it would be difficult to explore the options, especially in the case where you have limited options [such as with COPD],” he said. •