Impact of Age on Treatment Response to Endobronchial Valve Treatment in Patients With Severe Emphysema

OBJECTIVES: Endobronchial valve (EBV) treatment can significantly improve pulmonary function, exercise capacity, and quality of life in patients with advanced emphysema and lung hyperinflation. However, the impact of age on treatment response to EBV remains unclear, despite its increasing relevance in an aging population. This study aimed to assess the effect of age on clinical outcomes following EBV treatment in a real-world population.

METHODS: Baseline, 6-month, and 12-month follow-up data were obtained from our registry of EBV procedures performed between 2016 and 2024. Patients were stratified according to age: <70 years and ≥70 years. Age-related differences in relative changes in forced expiratory volume in 1 second (FEV1), residual volume (RV), 6-minute walk distance (6MWD), and St George's Respiratory Questionnaire (SGRQ) scores were assessed, together with safety outcomes, achievement of patient-specific goals, and patient satisfaction.

RESULTS: A total of 476 patients were included, of whom 79 (17%) were aged ≥70 years (range, 70-80 years). Both age groups demonstrated significant improvements in FEV1, RV, 6MWD, and SGRQ scores at both follow-up visits, with no significant differences between groups. Importantly, adverse events did not occur more frequently among older patients. Additionally, achievement of patient-specific goals was comparable between groups, although patients aged ≥70 years reported slightly greater satisfaction with treatment outcomes than those aged <70 years.

CONCLUSIONS: Our findings indicate that EBV treatment resulted in comparable clinical improvements and similar safety profiles regardless of patient age. These findings highlight the importance of referral and screening of older patients with emphysema to assess their eligibility for EBV treatment.