The mucus hyper-secretion that characterizes COPD has been shown to contribute to disease-related morbidity and mortality. Currently available medications for COPD do not specifically address mucus clearance, making this phenomenon an area of unmet need for patients, says Sanjay Sethi, MD. In 2010, the FDA approved the Lung Flute (Medical Acoustics, LCC) to treat COPD and other lung diseases characterized by retained secretions and congestion following positive findings from an 8-week study involving 40 patients. The hand-held respiratory device produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance.
An Extended Look
For a study published in Clinical and Translational Medicine, Dr. Sethi and colleagues sought long-term data to confirm observations from previous research showing that the Lung Flute benefits patients with COPD and chronic bronchitis. “Participants were randomized to the device as add-on therapy or to continue their standard COPD care,” says Dr. Sethi. “We assessed change in respiratory symptoms as measured with the Chronic COPD Questionnaire (CCQ) from baseline to 26 weeks in 69 patients.” Secondary endpoints included health status, BODE (BMI, Airflow Obstruction, Dyspnea, and Exercise Capacity) index score, and exacerbation frequency.
Patients using the Lung Flute reported significant improvements from baseline on the CCQ as well as on the St. George’s Respiratory Questionnaire, which measures quality of life. Those using the device breathed better, coughed less, and experienced reductions in sputum production when compared with the control group, whose COPD symptoms remained stable in the study.
The researchers also observed differences between groups on the BODE index. “Patients using the Lung Flute seemed to stabilize on the BODE index, whereas these scores worsened for the control group,” says Dr. Sethi. “The control group seemed to have faster deterioration with regard to both lung function and overall health status. Patients using the device also had fewer COPD exacerbations.” Any serious adverse effects that were observed among participants were determined to be unrelated to device use.
Implementing the Findings
Dr. Sethi suggests clinicians consider prescribing the Lung Flute to patients with COPD and chronic bronchitis. “Patients should still be prescribed standard treatment,” he notes. “They should also be asked if they’re having difficulty with mucus clearance in spite of that treatment. If patients aren’t having difficulty or the mucus is easily cleared in the morning, then they’re not good candidates for the device. However, if patients report difficulty clearing mucus and deal with it throughout the day, the Lung Flute should be considered as an add-on to standard treatment.”
Readings & Resources (click to view)
Sethi S, Yin J, Anderson P. Lung flute improves symptoms and health status in COPD with chronic bronchitis: a 26 week randomized controlled trial. Clin Transl Med. 2014;3:29. Available at www.clintransmed.com/content/3/1/29/abstract.
Myers T. Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care. 2007;52:1308-1326.
Anjuman N, Li N, Guarnera M, et al. Evaluation of lung flute in sputum samples for molecular analysis of lung cancer. Clin Transl Med. 2013;2:15.
Fujita A, Murata K, Takamori M. Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis. Respirology. 2009;14:899-902.