Oscillating Vest Keeps COPD Patients Out of Hospital

Allergies & Asthma

NEW ORLEANS – A wearable oscillating vest, designed for treatment of cystic fibrosis, appeared to reduce chronic obstructive pulmonary disease (COPD) exacerbations, according to a retrospective study reported here.

After 24 months of wearing the vest, patients achieved a 54.4% reduction in the annualized hospitalization rate for respiratory causes — a reduction in the rate of 1.32 to 0.60 (P=0.005), reported Tara Barto, MD, of Baylor College of Medicine in Houston. She said the decrease from baseline in hospitalizations had continued through 24 months.

In her poster discussion presentation at the 2019 CHEST meeting, sponsored by the American College of Chest Physicians, Barto also reported the following results:

  • A 24.9% increase in patients with zero hospitalization for respiratory causes in the prior year – from 39.5% to 64.4% (P=0.005)
  • A 20.1% decrease in patients with three or more hospitalizations for respiratory causes in the prior year – from 29% having multiple readmissions in the year prior to wearing the vest to 8.9% having three or more hospitalizations after using the vest therapy (P=0.001)
  • A 42% increase in patients who gave a favorable rating for “overall respiratory health” — rising from 8% of patients to 50% (P=0.018)

In the retrospective study with data derived from a registry maintained by the manufacturer of the vest, RespirTech of Plymouth, Minnesota, Barto and colleagues identified 219 individuals who used the vest and had a diagnosis of COPD but did not have any radiologic evidence of bronchiectasis. The researchers recorded hospitalizations due to respiratory causes for the year prior to initiating therapy with the vest and then followed the patients after they began wearing the vest.

For the registry, the individuals who wear the vest are contacted at 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months later by a a trained team of healthcare workers who ask the patients how they were doing at those time points. Barto and colleagues were able to assess that information to perform the study.

There are three other companies that make similar vests, but only RespirTech maintains the registry of users, Barto told MedPage Today.

The therapy required the patients to put on the vest with its high frequency oscillation directed at the chest wall for 30 minutes twice a day.

The wearable therapy vest provides external vibration, she explained. In cystic fibrosis and bronchiectasis patients the therapy is traditionally paired with nebulizer treatment, but for the COPD patients no other therapy was included.

Barto explained that RespirTech is not claiming its vest reduces events, but that it is the therapy – the high frequency chest wall oscillation – that helps keep patients out of the hospital.

“This is registry data,” Barto said in discussing the limitations of the study, “so we can’t necessarily identify causality. But can say that for those patients with COPD and without bronchiectasis we can definitely show changes in hospitalization rate as well as [the patients’] self-reported outcomes of respiratory health and ability to clear secretions with the use of high frequency chest wall oscillation.”

The team is now completing statistical analysis of the 24-month data for eventual publication in a peer-reviewed journal, Barto noted.

Asked for his perspective, Charlie Strange, MD, of the Medical University of South Carolina in Charleston, who was not involved with the study, said: “We have no medicines that do as well as this. This is phenomenal.”

“This is a vest that you put on and it shakes you,” he told MedPage Today. “It makes the chest secretions looser so it is possible to cough them up.”

He said that when the secretions are not removed they provide a nesting area for bacteria that can cause infection, and that can lead to a COPD exacerbation. “If you can keep the airways free of secretions, maybe you won’t end up in the hospital,” he suggested.

The vest is FDA approved for a number of pulmonary indications; the company registry of users included the patient group in the study, Barto noted.

Barto reported relevant financial relationships with RespirTech and Vertex.

Strange reported having no relevant relationships relating to the study.


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