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COPDAIRFLOW-3NCT03639051

Evaluation of the Safety and Efficacy of TLD in Patients with COPD

A study testing Targeted Lung Denervation (TLD) and Optimal Medical Care in people with COPD, run by Nuvaira, Inc. at 33 sites in 6 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

The purpose of this study is to confirm the safety and efficacy of the Nuvaira Lung Denervation System (Nuvaira System) in the treatment of COPD. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
COPD
What is being tested?
Targeted Lung Denervation (TLD) and Optimal Medical Care
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
464 participants
Where
33 sitesin 6 countries
Study dates
23 May 2019to Sep 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject ≥40 years of age at the time of consent;
  • Women of child bearing potential must not be pregnant, evidenced by a negative pregnancy test (blood or urine) pre-treatment, or lactating and agree not to become pregnant for the duration of the study;
  • Smoking history of at least 10 pack years;
  • Not smoking or using any other inhaled substance (e.g., cigarettes, vaping, cannabis, pipes) for a minimum of 2 months prior to consent and agrees to not start for the duration of the study;
  • Subject has received a flu vaccination within the 12 months prior to the procedure or agrees to obtain vaccination once it becomes available and agrees to annual vaccinations for the duration of the study;
  • Resting SpO2 ≥89% on room air at the time of screening;
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  • CAT score ≥10 at the time of screening;
  • Diagnosis of COPD with 25%≤ FEV1 ≤80% of predicted, PaCO2 ˂ 50 (if FEV1 ˂30%) and FEV1/FVC <70% (post-bronchodilator);
  • Documented history of ≥ 2 moderate COPD exacerbations or ≥ 1 severe COPD exacerbation leading to hospitalization in the 12 months prior to consent with at least one exacerbation occurring while the subject was on optimal medical care (taking LAMA and a LABA, or scheduled SABA or SAMA instead of either a LAMA or LABA, not both, as regular respiratory maintenance medication);
  • Subject is on optimal medical care at the time of consent;
  • If subject has participated in a formal pulmonary rehabilitation program recently, program completion must have occurred ≥3 months prior to consent; if in a maintenance program, subject agrees to continue their current program through their 12-month follow-up visit;
  • Subject is a candidate for bronchoscopy in the opinion of the physician or per hospital guidelines and is able to discontinue blood thinning medication peri-procedurally;
  • The subject is able and agrees to complete all protocol required baseline and follow-up tests and assessments including taking certain medications (e.g., azithromycin, prednisolone/prednisone);
  • Subject has provided written informed consent using a form that has been reviewed and approved by the Institutional Review Board (IRB)/Ethics Committee (EC).

Who cannot join

  • Body Mass Index <18 or >35;
  • Subject has an implantable electronic device and has not received appropriate medical clearance;
  • Uncontrolled diabetes in the opinion of the investigator;
  • Malignancy treated with radiation or chemotherapy within 1 year of consent;
  • Asthma as defined by the current Global Initiative for Asthma (GINA) guidelines;
  • Subject diagnosed with a dominant non-COPD lung disease or condition affecting the lungs, which is the main driver of the subjects clinical symptoms (e.g., cystic fibrosis, paradoxical vocal cord motion, eosinophilic granulomatosis with polyangiitis (EGPA), allergic bronchopulmonary aspergillosis, interstitial lung disease or active tuberculosis) or has a documented medical history of pneumothorax within 1 year of consent;
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  • Clinically relevant bronchiectasis, defined as severe single lobe or multilobar broncial wall thickening associated with airway dilation on CT scan leading to cough and tenacious sputum on most days;
  • Pre-existing diagnosis of pulmonary hypertension, clinical evidence of pulmonary hypertension (e.g., cardiovascular function impairment including peripheral edema) and mPAP ≥25 mmHg at rest by right heart catheterization (or estimated right ventricular systolic pressure >50 mmHg by echocardiogram if no previous right heart catheterization);
  • Myocardial infarction within last 6 months, EKG with evidence of life threatening arrhythmias or acute ischemia, pre-existing documented evidence of an LVEF <40%, stage C or D (ACC/AHA) or Class III or IV (NYHA) congestive heart failure, or any other past or present cardiac findings that make the subject an unacceptable candidate for a bronchoscopic procedure utilizing general anesthesia;
  • Surgical procedure(s) on the stomach, esophagus or pancreas performed ≤2 years of consent or ongoing related symptoms within the past year;
  • Symptomatic gastric motility disorder(s) (e.g., gastroparesis) as evidenced by a GCSI score ≥18.0, severe uncontrolled GERD (e.g., refractory heartburn, endoscopic esophagitis) or severe dysphagia (e.g., esophageal stricture, achalasia, esophageal spasm);
  • Any disease or condition that might interfere with completion of a procedure or this study (e.g., structural esophageal disorder, life expectancy <3 years);
  • Prior lung or chest procedure (e.g., lung transplant, LVRS, BLVR, lung implant, metal stent, valves, median sternotomy, bullectomy, lobectomy, segmentectomy or other interventional lung or chest procedure) performed ≤1 year of consent; NOTE: Any metal in the chest must be ≥5 cm away from the anticipated treatment location(s). Subjects with explanted lung valve(s) allowed if explant occurred ≥3 months prior to treatment.
  • Daily use of >10 mg of prednisone or its equivalent at the time of consent;
  • Chronic use of >40 mg MEDD opioid only medication per day;
  • Known contraindication or allergy to medications required for bronchoscopy or general anesthesia (e.g., lidocaine, atropine, propofol, sevoflurane) that cannot be medically controlled;
  • Baseline chest CT scan reveals bronchi anatomy cannot be fully treated with available catheter sizes, presence of severe emphysema >50%, lobar attenuation area or severe bullous disease (>1/3 hemithorax) (as determined by the CT core lab using a single density mask threshold of -950 HU) or discovery of a mass that requires treatment;
  • Subject is currently enrolled in another interventional clinical trial that has not completed follow-up.

Trial locations and contacts

33 sites in 6 countries.

33 sites in 6 countries

United States20 sites
  • University of Michigan

    Ann Arbor, Michigan, 48109

  • University of Alabama at Birmingham (UAB) Lung Health Center

    Birmingham, Alabama, 35294

  • Lahey Hospital & Medical Center

    Burlington, Massachusetts, 01805

  • Medical University of South Carolina (MUSC)

    Charleston, South Carolina, 29425

  • University of Chicago

    Chicago, Illinois, 60637

  • Ohio State University Wexner Medical Center

    Columbus, Ohio, 43210

  • Duke University

    Durham, North Carolina, 27710

  • Suburban Lung Associates

    Elk Grove Village, Illinois, 60007

  • St. Davids HealthCare

    Georgetown, Texas, 78626

  • Spectrum Health Medical Group

    Grand Rapids, Michigan, 49546

  • Houston Methodist Hospital

    Houston, Texas, 77030

  • Ascension St. Vincent's

    Jacksonville, Florida, 32204

  • University of Louisville

    Louisville, Kentucky, 40202

  • Temple Lung Center

    Philadelphia, Pennsylvania, 19140

  • HonorHealth

    Phoenix, Arizona, 85258

  • First Health of the Carolinas

    Pinehurst, North Carolina, 28374

  • University of Pittsburgh Medical Center (UPMC)

    Pittsburgh, Pennsylvania, 15219

  • UC Davis

    Sacramento, California, 95817

  • Washington University

    St Louis, Missouri, 63110

  • Harbor UCLA

    Torrance, California, 90502

Other trials in United States

France8 sites
  • Hopital de la Cavale Blanche

    Brest

  • CHU de Grenoble

    Grenoble, Cedex 9, 38043

  • Arnaud de Villeneuve Hospital

    Montpellier

  • Hopital Pasteur

    Nice

  • Bichat-Claude Bernard Hospital

    Paris

  • CHU de Reims

    Reims

  • CHU de Strasbourg

    Strasbourg

  • Hopital Larrey

    Toulouse, Cedex 9, 31400

Other trials in France

Netherlands2 sites
  • UMC

    Amsterdam

  • University Medical Center Groningen (UMCG)

    Groningen

Other trials in Netherlands

Austria1 site
  • Krankenhaus Nord - Klinik Floridsdorf

    Vienna

Other trials in Austria

Germany1 site
  • Thorax Klinik Heidelberg

    Heidelberg

Other trials in Germany

United Kingdom1 site
  • Royal Brompton Harefield Trust

    London

Other trials in United Kingdom

About this study

Official title: A Multicenter, Randomized, Sham-controlled Study to Evaluate Safety and Efficacy After Treatment with the Nuvaira™ Lung Denervation System in Patients with Chronic Obstructive Pulmonary Disease (COPD)

The purpose of this study is to confirm the safety and efficacy of the Nuvaira Lung Denervation System (Nuvaira System) in the treatment of COPD.

Read the detailed description

The primary objective of this study is to demonstrate the superiority of treatment with the Nuvaira Lung Denervation System (Active Treatment arm) compared to a sham procedure (Sham Control arm) to decrease moderate or severe exacerbations in subjects with COPD on optimal medical care.

The secondary objective is to compare long-term safety, and other efficacy assessments between the Active Treatment arm and the Sham Control arm.

Conditions
COPD
Being tested
Targeted Lung Denervation (TLD), Optimal Medical Care
Medical subject headings
Pulmonary Disease, Chronic Obstructive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Targeted Lung Denervation (TLD)Device

    Also called TLD, TLD Therapy

    Targeted Lung Denervation (TLD) Therapy is a bronchoscopically guided, minimally invasive procedure using the Nuvaira™ Lung Denervation System.

  • Optimal Medical CareOther

    Taking regular maintenance medication that minimally includes a long-acting muscarinic antagonist (LAMA) and a long-acting beta2-agonist (LABA).

Study groups in NCT03639051
Study groupRoleWhat they receive
Active TreatmentExperimentalTarget Lung Denervation (TLD) with the Nuvaira Lung Denervation System (RF energy delivered) and optimal medical care for COPD.
Receives: Device: Targeted Lung Denervation (TLD); Other: Optimal Medical Care
Sham ControlSham comparatorSham Targeted Lung Denervation (TLD) procedure with the Nuvaira Lung Denervation System (catheter placement and balloon deployment in all treatment locations, no RF energy delivered) and optimal medical care for COPD.
Receives: Other: Optimal Medical Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Moderate or severe COPD exacerbations

    A COPD exacerbation will be defined as a complex of respiratory events/symptoms (increase or new onset) of more than one of the following: cough, sputum, wheezing, dyspnea or chest tightness with at least one symptom lasting three days requiring treatment with antibiotics and/or systemic steroids (moderate exacerbation) and/or hospital admission (severe exacerbation).

    Measured: Randomization to 12 Months

Secondary outcomes (10)
  1. Time to first severe COPD exacerbation

    Defined as a comparison between study arms of the survival distributions for events based on log-rank tests

    Measured: Randomization to 12 Months

  2. Time to first severe COPD exacerbation (Subgroup)

    Defined as a comparison between study arms of the survival distributions for events based on log-rank tests, only for the subgroup of subjects who had a severe COPD exacerbation in the year prior to randomization.

    Measured: Randomization to 12 months

  3. Change in St. George's Respiratory Questionnaire COPD Version (SGRQ-C) Total score

    Defined as a comparison between study arms of the mean change in FVC based on a linear model for change in SGRQ-C, adjusted for baseline SGRQ-C.

    The SGRQ-C is a disease-specific HRQL questionnaire with a total and three component scores for: symptoms, activity and impacts; each score ranges from 0 (no impairment) to 100 (worst possible). A difference in four units in the SGRQ-C score is considered the minimum clinically important difference (MCID).

    Measured: Randomization to 12 months

  4. Change in FVC

    Defined as a comparision between study arms of the mean change in FVC based on a linear model for change in FVC, adjusted for baseline FVC.

    Measured: Randomization to 12 Months

  5. Change in FEV1

    Defined as a comparison between study arms of the mean change in FEV1 based on a linear model for change in FEV1, adjusted for baseline FEV1.

    Measured: Randomization to 12 months

  6. Transition Dyspnea Index (TDI)

    Defined as a comparison between study arms of the TDI based on a linear model for change in TDI.

    Measured: Randomization to 12 months

  7. Change in RV

    Defined as a comparison between study arms of the mean change in RV based on a linear model for change in RV, adjusted for baseline RV.

    Measured: Randomization to 12 months

  8. Time to first respiratory-related hospitalization

    Defined as a comparison between study arms of the survival distributions for events based on log-rank tests.

    Measured: Randomization to 12 Months

  9. Change in Short Form Health Survey (SF-36) total score

    Defined as a comparison between study arms of the mean change in SF-36 total score based on a linear model for change in SF-36 total score, adjusted for baseline SF-36 total score.

    SF-36 is composed of eight multi-item scales (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, Mental Health), with scores for each of these scales (or dimensions) ranging from 0 to 100. Higher scores indicate higher HRQoL.

    Measured: Randomization to 12 Months

  10. CAT responders

    Defined as a comparison between study arms of the proportion of subjects with a greater than or equal to 2 point decrease in CAT.

    The CAT is a disease-specific HRQL with eight questions; each score ranges from 0 (no impairment) to 5 (worst possible). The CAT has a scoring range of 0-40. Higher scores denote a more severe impact of COPD on a patient's life. A difference in 2 units in the CAT score over 2 to 3 months suggests a clinically significant difference or change in health status.

    Measured: Randomization to 12 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2018
  2. Study start23 May 2019
  3. Primary completion1 Oct 2024
  4. Study completionSep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Subjects will be randomized with equal allocation (1:1) into two arms: TLD therapy plus optimal medical care (Active Treatment) and optimal medical care (Sham Control). Randomization of subjects will be stratified based on investigational site, participation in a pulmonary rehabilitation maintenance program and baseline use of an inhaled corticosteroid at the time of enrollment.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
464 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03639051
Sponsor's protocol ID
D0543
Acronym
AIRFLOW-3
Status last verified
Nov 2024
First submitted
8 Aug 2018
Last updated
14 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).

Publications

  • Shah PL, Slebos DJ, Sue R, Bhatt SP, Ghattas C, Strange C, Degano B, Valipour A, Eisenmann S, De Cardenas J, Marquette CH, Soto-Soto J, Sciurba FC, Conway F, Tonkin J, Tana A, Marchetti N, Hartman JE, Heluain V, Guibert N, Criner GJ. Randomized Sham-controlled Trial of Targeted Lung Denervation in Patients with Chronic Obstructive Pulmonary Disease (AIRFLOW-3). Am J Respir Crit Care Med. 2025 Dec;211(12):2318-2329. doi: 10.1164/rccm.202502-0404OC.

    PubMed 40920914
  • Agrawal A. Interventional Pulmonology: Diagnostic and Therapeutic Advances in Bronchoscopy. Am J Ther. 2021 Feb 9;28(2):e204-e216. doi: 10.1097/MJT.0000000000001344.

    PubMed 33590989
  • Slebos DJ, Degano B, Valipour A, Shah PL, Deslee G, Sciurba FC; AIRFLOW-3 Trial Study Group. Design for a multicenter, randomized, sham-controlled study to evaluate safety and efficacy after treatment with the Nuvaira(R) lung denervation system in subjects with chronic obstructive pulmonary disease (AIRFLOW-3). BMC Pulm Med. 2020 Feb 13;20(1):41. doi: 10.1186/s12890-020-1058-5.

    PubMed 32054473

Questions about this trial

What is this clinical trial studying?

A study testing Targeted Lung Denervation (TLD) and Optimal Medical Care in people with COPD, run by Nuvaira, Inc. at 33 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 14 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States, France, Netherlands, Austria, Germany and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Moderate or severe COPD exacerbations (time frame: Randomization to 12 Months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03639051, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Nov 2024.

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