Emphysema or COPDBREATHE-2NCT05949645
Study to Assess Safety, Feasibility, and Preliminary Efficacy of the Apreo Implant for Severe Emphysema
A study testing Apreo Implant Group in people with Emphysema or COPD, run by Apreo Health, Inc. at 3 sites in 3 countries.
Trial summary
The goal of this clinical trial is to test the feasibility of an implant for severe emphysema in up to 30 participants at up to 5 study centers located in Europe and the United Kingdom. Read more about this study
- Who is it for?
- Ages 35 to 80 years
- Conditions the study is for
- Emphysema or COPD
- What is being tested?
- Apreo Implant Group
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 3 sitesin 3 countries
- Study dates
- 15 Aug 2023to 1 Jun 2026
- 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 35 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 35 and ≤ 80 years old
- Computed tomography (CT) scan evidence of homogeneous or heterogeneous emphysema
- At least one target lobe with > 35% destruction (percent of voxels with < -950 Hounsfield units on CT)
- Post-bronchodilator ratio of FEV1/FVC < 0.7 at screening
- Post-bronchodilator FEV1 percent predicted ≥15% and ≤50% of predicted at screening
- Post-bronchodilator RV > 180% predicted
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- Post-bronchodilator RV/TLC ≥ 0.55 at screening
- Marked dyspnea, scoring ≥ 2 on the modified Medical Research Council scale of 0-4
- Cotinine testing or carboxyhemoglobin at screening indicates nonsmoker and stopped smoking at least 8 weeks before entering the trial and agrees to refrain from smoking for duration of study participation
- Participation in a pulmonary rehabilitation program and/or confirmed to have been engaged or attempted regular physical activity in the 12 months prior to the first Apreo Procedure and agrees to continue or restart regular physical activity for the duration of the study
- Fully vaccinated for Covid-19 (up to date per local government guidelines) and has current pneumococcus and influenza vaccination (or documented clinical intolerance)
- Cognitively and physically able to provide written informed consent and complete participant questionnaires
Who cannot join
- Arterial blood on room air: PaCO2 > 50 mmHg (8 kPa) or PaO2 ≤ 45 mmHg (6 kPa)
- DLCO <20% at screening
- Steroid therapy of 10 mg prednisolone (prednisone) or more per day
- Two or more hospitalizations for acute exacerbations of COPD or respiratory infections in the past year before enrollment
- Any acute exacerbation of COPD or respiratory infection less than 4 weeks before the first Apreo Procedure
- Previous lung volume reduction surgery or lobectomy, segmentectomy or bullectomy, vapor, glue, or other pulmonary device implant
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- Known or suspected history of pulmonary arterial hypertension with a PASP > 50 mmHg on echocardiogram or mPAP > 25 mmHg on a right heart catheterization
- Presence of a giant bulla (≥ 30% of hemithorax)
- History of adult asthma or chronic bronchitis
- Presence of suspicious pulmonary nodule/infiltrate that requires additional follow-up, diagnostics or treatment
- Unequivocal and symptomatic bronchiectasis
- Unequivocal lung cancer or other current cancer diagnosis except non-metastasized basal cell skin cancer
- Uncontrolled hypertension (blood pressure that is inadequately treated or resistant to treatment) with a systolic > 200 mmHg or diastolic > 110 mmHg at screening or prior to first Apreo Procedure
- Uncorrectable coagulopathy or other condition likely to increase risk of peri- or post- Apreo Procedure bleeding
- On anticoagulant or antiplatelet therapy and unable or unwilling to hold for Apreo Procedure
- History of myocardial infarction or unstable angina within past 6 months
- History of a stroke less than 1 year before the first Apreo Procedure
- Clinical history of heart failure with documented LVEF ≤ 40%
- Clinical history of diabetes with a HbA1c > 9.0%
- Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m2 (CKD-EPI) OR participant with kidney failure (Stage 5 kidney disease)
- Mechanical ventilator dependence except participants using nocturnal bi-level positive airway pressure (biPAP) or continuous positive airway pressure (CPAP) are allowed if it would not preclude safe implantation of the study device
- Pregnant, lactating, or women of childbearing potential who plan to become pregnant within the study duration
- Known hypersensitivity to nitinol
- Significantly immunocompromised, such as organ transplant recipients, those with congenital immune deficiencies, AIDS, or severe rheumatoid arthritis
- Any disease or condition likely to limit survival to less than one year
- Concomitant illnesses or medications that may pose a significant increased risk for complications following an Apreo Procedure
- Currently enrolled in another trial and actively receiving experimental treatment
- Any condition in the opinion of the investigator that would interfere with safe and complete collection of study data including the safe conduction of bronchoscopy procedures
Trial locations and contacts
3 sites in 3 countries.
3 sites in 3 countries
About this study
Official title: Bronchoscopic Release of Air Trapped in Hyperinflated Emphysematous Lung
The goal of this clinical trial is to test the feasibility of an implant for severe emphysema in up to 30 participants at up to 5 study centers located in Europe and the United Kingdom. The main questions this clinical trial aim to answer are: Is it safe? Does it work?
Participants who meet eligibility criteria will have up to two procedures 30 days apart, in which up to 3 implants will be placed in each lung during the procedure(s). Participants will be asked to return for follow-up visits at 30 days, and 3, 6, and 12 months after the procedure(s).
Read the detailed description
This is a first-in-human, prospective, multi-center, single-arm study assessing the safety, feasibility and preliminary efficacy of the Apreo Implant for severe emphysema in up to 30 participants. Initially all participants will undergo an Apreo Procedure involving placement of up to three implants in a native bronchial tree of one lung followed by a second Apreo Procedure 30 days later to place up to three implants in the contralateral native lung bronchial tree if indicated.
Once the fifth participant has undergone his or her first implantation procedure, implantations in currently enrolled or new participants will be paused to allow for a Safety Review Committee (SRC) to convene and review safety data once the 5th participant has completed the 7-day phone follow-up after their second Apreo Procedure (or first if only one procedure). This would be at a minimum acute procedural safety for up to 10 implantation procedures conducted in these first 5 participants, 30-day safety assessments for all 5 participants after their first lung implantations, bronchoscopic inspection 30 days after implantation of all implants in the first lung, and 7-day safety data after their first and second lung implantations. The SRC will provide comments and recommendations, including the restart of implantation for new participants, if deemed appropriate.
After the first 10 participants have completed the 7-day phone follow-up after the second Apreo Procedure (or first if only one procedure), their safety data will be reviewed by the SRC. This would include at a minimum acute procedural safety for up to 20 implantation procedures conducted in these first 10 participants, 30-day safety assessments for all 10 participants after their first lung implantations, bronchoscopic inspection 30 days after implantation of all implants in the first lung, and 7-day safety data after their first and second lung implantations. Following the review of the first 10 participants' safety data, the SRC may allow any subsequently enrolled participants to undergo one Apreo Procedure (rather than two separate procedures if appropriate for a participant) to deploy Apreo Implants in both the left and right lung airways as indicated or to continue to have all participants undergo two separate Apreo Procedures if indicated. A total of up to 30 participants will be enrolled overall.
All participants will be followed at 30 days, three, six and twelve months post the first Apreo Procedure and assessments include adverse event (AE) assessment, pulmonary function testing, bronchoscopy, and quality of life assessments (Day 30, and 3, 6, and 12 months) and an inspiratory/expiratory chest CT at 6 and 12 months. A phone follow-up for AE assessment will occur at 7 days after each Apreo Procedure.
- Conditions
- Emphysema or COPD
- Being tested
- Apreo Implant Group
- Keywords
- hyperinflation, air-trapping, emphysema, COPD
- Medical subject headings
- Emphysema, Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Apreo Implant GroupDevice
One or two procedures involving placement of up to three Apreo implants in the bronchial tree of each lung.
| Study group | Role | What they receive |
|---|---|---|
| Apreo Implant Group | Experimental | This group will undergo up to 2 procedures and will receive up to 3 implants in each lung. Receives: Device: Apreo Implant Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of Serious Adverse Events (SAE) at 6 Months
Rate of occurrence of serious adverse events related to the study device and/or study procedure through 6 months post-study procedure #1
Measured: 6 Months
Secondary outcomes (71)
Device Evaluation: Device Deployment Assessment
Evaluation of the ability to deploy the Apreo Implant in target airways (There is no scale - questions are assessed individually)
Measured: During Procedure
Device Evaluation: Device Usability Survey
Evaluate operator device use challenges (There is no scale - questions are assessed individually)
Measured: During Procedure
Device Evaluation: Instructions for Use Survey
Evaluate operator understanding of instructions for use (There is no scale - questions are assessed individually)
Measured: During Procedure
Efficacy Evaluation: Airway Patency at 30 Days
Assess implant obstruction bronchoscopically using semi-quantitative scale (0=no narrowing of the airway to 5= >75% to 100% narrowing)
Measured: 30 Days
Efficacy Evaluation: Airway Patency at 3 Months
Assess implant obstruction bronchoscopically using semi-quantitative scale (0=no narrowing of the airway to 5= >75% to 100% narrowing)
Measured: 3 Months
Efficacy Evaluation: Airway Patency at 6 Months
Assess implant obstruction bronchoscopically using semi-quantitative scale (0=no narrowing of the airway to 5= >75% to 100% narrowing)
Measured: 6 Months
Efficacy Evaluation: Airway Patency at 12 Months
Assess implant obstruction bronchoscopically using semi-quantitative scale (0=no narrowing of the airway to 5= >75% to 100% narrowing)
Measured: 12 Months
Efficacy Evaluation: Mucus Assessment at 30 Days
Assess mucus within the Apreo Implant bronchoscopically using semi-quantitative scale (0=No mucus to 5=copious mucus)
Measured: 30 Days
Efficacy Evaluation: Mucus Assessment at 3 Months
Assess mucus within the Apreo Implant bronchoscopically using semi-quantitative scale (0=No mucus to 5=copious mucus)
Measured: 3 Months
Efficacy Evaluation: Mucus Assessment at 6 Months
Assess mucus within the Apreo Implant bronchoscopically using semi-quantitative scale (0=No mucus to 5=copious mucus)
Measured: 6 Months
Efficacy Evaluation: Mucus Assessment at 12 Months
Assess mucus within the Apreo Implant bronchoscopically using semi-quantitative scale (0=No mucus to 5=copious mucus)
Measured: 12 Months
Efficacy Evaluation: Computed Tomography (CT) Scan at 6 Months
CT evaluation of Apreo Implant diameter
Measured: 6 Months
Efficacy Evaluation: Computed Tomography (CT) Scan at 12 Months
CT evaluation of Apreo Implant diameter
Measured: 12 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 1-3 Days
Change in FEV1 between Baseline and 1-3 days post-procedure #1
Measured: 1-3 Days
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 30 Days
Change in FEV1 between Baseline and 30 days post-procedure #1
Measured: 30 Days
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 3 Months
Change in FEV1 between Baseline and 3 months post-procedure #1
Measured: 3 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 6 Months
Change in FEV1 between Baseline and 6 months post-procedure #1
Measured: 6 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 12 Months
Change in FEV1 between Baseline and 12 months post-procedure #1
Measured: 12 Months
Efficacy Evaluation: Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) at 6 Months
Change in DLCO between baseline and 6 months post-procedure
Measured: 6 Months
Efficacy Evaluation: Residual Volume (RV) at 6 Months
Change in RV between baseline and 6 months as assessed by quantitative CT
Measured: 6 Months
Efficacy Evaluation: Residual Volume (RV) at 12 Months
Change in RV between baseline and 12 months as assessed by quantitative CT
Measured: 12 Months
Efficacy Evaluation: Arterial Blood Gas (ABG): PaO2 at 6 Months
Change in PaO2 between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: Arterial Blood Gas (ABG): PaCO2 at 6 Months
Change in PaCO2 between baseline and 6 months
Measured: 6 Months
Safety: Procedural Complications
Percentage of participants with acute procedural complications within 24 hours of study procedure
Measured: Through 24 hours post-procedure
Safety: Rate of SAEs
Rate of occurrence of serious adverse events related to the device and/or Apreo procedure through 12 months
Measured: Through 12 Months
Safety: Rate of Adverse Device Effects
Rate of adverse device effects through 12 months post-procedure
Measured: Through 12 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 1-3 Days
Change in FEV1/FVC between baseline and 1-3 days post-procedure #1
Measured: 1-3 Days
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 30 Days
Change in FEV1/FVC between baseline and 30 days post-procedure #1
Measured: 30 Days
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 3 Months
Change in FEV1/FVC between baseline and 3 months post-procedure #1
Measured: 3 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 6 Months
Change in FEV1/FVC between baseline and 6 months post-procedure #1
Measured: 6 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 12 Months
Change in FEV1/FVC between baseline and 12 months post-procedure #1
Measured: 12 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 1-3 Days
Change in RV between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 30 Days
Change in RV between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 3 Months
Change in RV between baseline and 3 Months
Measured: 3 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 6 Months
Change in RV between baseline and 6 Months
Measured: 6 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 12 Months
Change in RV between baseline and 12 Months
Measured: 12 Months
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 1-3 Days
Change in RV/TLC between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 30 Days
Change in RV/TLC between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 3 Months
Change in RV/TLC between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 6 Months
Change in RV/TLC between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 12 Months
Change in RV/TLC between baseline and 12 months
Measured: 12 Months
Efficacy Evaluation: Forced Vital Capacity (FVC) at 1-3 Days
Change in FVC between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: Forced Vital Capacity (FVC) at 30 Days
Change in FVC between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: Forced Vital Capacity (FVC) at 3 Months
Change in FVC between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: Forced Vital Capacity (FVC) at 6 Months
Change in FVC between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: Forced Vital Capacity (FVC) at 12 Months
Change in FVC between baseline and 12 months
Measured: 12 Months
Efficacy Evaluation: Six Minute Walk Test (6MWT) at 1-3 Days
Change in 6MWT between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: Six Minute Walk Test (6MWT) at 30 Days
Change in 6MWT between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: Six Minute Walk Test (6MWT) at 3 Months
Change in 6MWT between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: Six Minute Walk Test (6MWT) at 6 Months
Change in 6MWT between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: Six Minute Walk Test (6MWT) at 12 Months
Change in 6MWT between baseline and 12 months
Measured: 12 Months
Efficacy Evaluation: Modified Borg Dyspnoea Scale at 1-3 Days
Change in modified BORG Dyspnoea Scale between baseline and 1-3 days (scale is 0= no difficulty breathing to 10=maximal difficulty)
Measured: 1-3 Days
Efficacy Evaluation: Modified Borg Dyspnoea Scale at 30 Days
Change in modified BORG Dyspnoea Scale between baseline and 30 days (scale is 0= no difficulty breathing to 10=maximal difficulty)
Measured: 30 Days
Efficacy Evaluation: Modified Borg Dyspnoea Scale at 3 Months
Change in modified BORG Dyspnoea Scale between baseline and 3 months (scale is 0= no difficulty breathing to 10=maximal difficulty)
Measured: 3 Months
Efficacy Evaluation: Modified Borg Dyspnoea Scale at 6 Months
Change in modified BORG Dyspnoea Scale between baseline and 6 months (scale is 0= no difficulty breathing to 10=maximal difficulty)
Measured: 6 Months
Efficacy Evaluation: Modified Borg Dyspnoea Scale at 12 Months
Change in modified BORG Dyspnoea Scale between baseline and 12 months (scale is 0= no difficulty breathing to 10=maximal difficulty)
Measured: 12 Months
Efficacy Evaluation: COPD Assessment Test (CAT) at 1-3 Days (CAT scores range from 0 to 40, with higher score denoting higher impact of COPD on a participant's life)
Change in CAT between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: COPD Assessment Test (CAT) at 30 Days (CAT scores range from 0 to 40, with higher score denoting higher impact of COPD on a participant's life)
Change in CAT between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: COPD Assessment Test (CAT) at 3 Months (CAT scores range from 0 to 40, with higher score denoting higher impact of COPD on a participant's life)
Change in CAT between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: COPD Assessment Test (CAT) at 6 Months (CAT scores range from 0 to 40, with higher score denoting higher impact of COPD on a participant's life)
Change in CAT between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: COPD Assessment Test (CAT) at 12 Months (CAT scores range from 0 to 40, with higher score denoting higher impact of COPD on a participant's life)
Change in CAT between baseline and 12 months
Measured: 12 Months
Efficacy Evaluation: St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) at 1-3 Days (scores range from 0 to 100, with higher scores indicating more limitations to daily living)
Change in SGRQ-C between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) at 30 Days (scores range from 0 to 100, with higher scores indicating more limitations to daily living)
Change in SGRQ-C between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) at 3 Months (scores range from 0 to 100, with higher scores indicating more limitations to daily living)
Change in SGRQ-C between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) at 6 Months (scores range from 0 to 100, with higher scores indicating more limitations to daily living)
Change in SGRQ-C between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) at 12 Months (scores range from 0 to 100, with higher scores indicating more limitations to daily living)
Change in SGRQ-C between baseline and 12 months
Measured: 12 Months
Efficacy Evaluation: Modified Medical Research Council (mMRC) Dyspnea Scale (0=no breathlessness except with strenuous exercise to 4=too breathless to leave the house or breathless when dressing or undressing) at 1-3 Days
Change in mMRC between baseline and 1-3 days
Measured: 1-3 Days
Efficacy Evaluation: Modified Medical Research Council (mMRC) Dyspnea Scale (0=no breathlessness except with strenuous exercise to 4=too breathless to leave the house or breathless when dressing or undressing) at 30 Days
Change in mMRC between baseline and 30 days
Measured: 30 Days
Efficacy Evaluation: Modified Medical Research Council (mMRC) Dyspnea Scale (0=no breathlessness except with strenuous exercise to 4=too breathless to leave the house or breathless when dressing or undressing) at 3 Months
Change in mMRC between baseline and 3 months
Measured: 3 Months
Efficacy Evaluation: Modified Medical Research Council (mMRC) Dyspnea Scale (0=no breathlessness except with strenuous exercise to 4=too breathless to leave the house or breathless when dressing or undressing) at 6 Months
Change in mMRC between baseline and 6 months
Measured: 6 Months
Efficacy Evaluation: Modified Medical Research Council (mMRC) Dyspnea Scale (0=no breathlessness except with strenuous exercise to 4=too breathless to leave the house or breathless when dressing or undressing) at 12 Months
Change in mMRC between baseline and 12 months
Measured: 12 Months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jul 2023
- Study start15 Aug 2023
- Primary completion8 Oct 2024
- Study completion1 Jun 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Emphysema or COPDStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Apreo Health, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05949645
- Sponsor's protocol ID
- CIP-0003
- Acronym
- BREATHE-2
- Status last verified
- Mar 2026
- First submitted
- 10 Jul 2023
- Last updated
- 31 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Tana A, Valipour A, Ing A, Steinfort DP, Orton CM, Klooster K, Klemm T, Williamson JP, Christie JJ, Garner JL, Koster TD, Welz K, van Dijk M, Mayse ML, Shah PL, Slebos DJ; BREATHE Study Group. Airway Scaffolds for Emphysema-related Hyperinflation: Six-Month Results from the BREATHE Trial. Am J Respir Crit Care Med. 2025 Jul;211(7):1175-1184. doi: 10.1164/rccm.202502-0378OC.
PubMed 40387356
Study at a glance
From the registry record, last updated by the sponsor on 31 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Bronchoscopic Release of Air Trapped in Hyperinflated Emphysematous Lung
- ClinicalTrials.gov ID
- NCT05949645
- Acronym / sponsor ID
- BREATHE-2 / CIP-0003
- Conditions
- Emphysema or COPD
- Keywords
- hyperinflation, air-trapping, emphysema, COPD
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Apreo Health, Inc.Industry (pharma, biotech, devices)
- Study start
- 15 Aug 2023 (actual)
- Primary completion
- 8 Oct 2024 (actual)
- Study completion
- 1 Jun 2026 (estimated)
- First posted
- 18 Jul 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to test the feasibility of an implant for severe emphysema in up to 30 participants at up to 5 study centers located in Europe and the United Kingdom. The main questions this clinical trial aim to answer are: Is it safe? Does it work?
Participants who meet eligibility criteria will have up to two procedures 30 days apart, in which up to 3 implants will be placed in each lung during the procedure(s). Participants will be asked to return for follow-up visits at 30 days, and 3, 6, and 12 months after the procedure(s).
Detailed description
This is a first-in-human, prospective, multi-center, single-arm study assessing the safety, feasibility and preliminary efficacy of the Apreo Implant for severe emphysema in up to 30 participants. Initially all participants will undergo an Apreo Procedure involving placement of up to three implants in a native bronchial tree of one lung followed by a second Apreo Procedure 30 days later to place up to three implants in the contralateral native lung bronchial tree if indicated.
Once the fifth participant has undergone his or her first implantation procedure, implantations in currently enrolled or new participants will be paused to allow for a Safety Review Committee (SRC) to convene and review safety data once the 5th participant has completed the 7-day phone follow-up after their second Apreo Procedure (or first if only one procedure). This would be at a minimum acute procedural safety for up to 10 implantation procedures conducted in these first 5 participants, 30-day safety assessments for all 5 participants after their first lung implantations, bronchoscopic inspection 30 days after implantation of all implants in the first lung, and 7-day safety data after their first and second lung implantations. The SRC will provide comments and recommendations, including the restart of implantation for new participants, if deemed appropriate.
After the first 10 participants have completed the 7-day phone follow-up after the second Apreo Procedure (or first if only one procedure), their safety data will be reviewed by the SRC. This would include at a minimum acute procedural safety for up to 20 implantation procedures conducted in these first 10 participants, 30-day safety assessments for all 10 participants after their first lung implantations, bronchoscopic inspection 30 days after implantation of all implants in the first lung, and 7-day safety data after their first and second lung implantations. Following the review of the first 10 participants' safety data, the SRC may allow any subsequently enrolled participants to undergo one Apreo Procedure (rather than two separate procedures if appropriate for a participant) to deploy Apreo Implants in both the left and right lung airways as indicated or to continue to have all participants undergo two separate Apreo Procedures if indicated. A total of up to 30 participants will be enrolled overall.
All participants will be followed at 30 days, three, six and twelve months post the first Apreo Procedure and assessments include adverse event (AE) assessment, pulmonary function testing, bronchoscopy, and quality of life assessments (Day 30, and 3, 6, and 12 months) and an inspiratory/expiratory chest CT at 6 and 12 months. A phone follow-up for AE assessment will occur at 7 days after each Apreo Procedure.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Apreo Implant Group | Experimental | Device: Apreo Implant GroupThis group will undergo up to 2 procedures and will receive up to 3 implants in each lung. |
Who may qualify
- Ages
- 35 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Age ≥ 35 and ≤ 80 years old
- Computed tomography (CT) scan evidence of homogeneous or heterogeneous emphysema
- At least one target lobe with > 35% destruction (percent of voxels with < -950 Hounsfield units on CT)
- Post-bronchodilator ratio of FEV1/FVC < 0.7 at screening
- Post-bronchodilator FEV1 percent predicted ≥15% and ≤50% of predicted at screening
Key exclusion criteria (28 listed)
- Arterial blood on room air: PaCO2 > 50 mmHg (8 kPa) or PaO2 ≤ 45 mmHg (6 kPa)
- DLCO <20% at screening
- Steroid therapy of 10 mg prednisolone (prednisone) or more per day
- Two or more hospitalizations for acute exacerbations of COPD or respiratory infections in the past year before enrollment
- Any acute exacerbation of COPD or respiratory infection less than 4 weeks before the first Apreo Procedure
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Apreo Implant GroupOne or two procedures involving placement of up to three Apreo implants in the bronchial tree of each lung. | Device | Apreo Implant Group |
Primary outcome
Rate of Serious Adverse Events (SAE) at 6 Months
Time frame: 6 Months
Rate of occurrence of serious adverse events related to the study device and/or study procedure through 6 months post-study procedure #1
71 secondary outcomes
Device Evaluation: Device Deployment Assessment
Time frame: During Procedure
Device Evaluation: Device Usability Survey
Time frame: During Procedure
Device Evaluation: Instructions for Use Survey
Time frame: During Procedure
Efficacy Evaluation: Airway Patency at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Airway Patency at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Airway Patency at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Airway Patency at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Mucus Assessment at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Mucus Assessment at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Mucus Assessment at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Mucus Assessment at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Computed Tomography (CT) Scan at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Computed Tomography (CT) Scan at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 1-3 Days
Time frame: 1-3 Days
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Forced Expiratory Volume in 1 Second (FEV1) at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Residual Volume (RV) at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Residual Volume (RV) at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Arterial Blood Gas (ABG): PaO2 at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Arterial Blood Gas (ABG): PaCO2 at 6 Months
Time frame: 6 Months
Safety: Procedural Complications
Time frame: Through 24 hours post-procedure
Safety: Rate of SAEs
Time frame: Through 12 Months
Safety: Rate of Adverse Device Effects
Time frame: Through 12 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 1-3 Days
Time frame: 1-3 Days
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Forced Expiratory Volume at 1 Second/ Forced Vital Capacity (FEV1/FVC) at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 1-3 Days
Time frame: 1-3 Days
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 6 Months
Time frame: 6 Months
Efficacy Evaluation: Residual Volume (RV) Assessed by Pulmonary Function Testing at 12 Months
Time frame: 12 Months
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 1-3 Days
Time frame: 1-3 Days
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 30 Days
Time frame: 30 Days
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 3 Months
Time frame: 3 Months
Efficacy Evaluation: Residual Volume/Total Lung Capacity (RV/TLC) at 6 Months
Time frame: 6 Months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Mar 2026.
- Derived from this study: PubMed 40387356Tana A, Valipour A, Ing A, Steinfort DP, Orton CM, Klooster K, Klemm T, Williamson JP, Christie JJ, Garner JL, Koster TD, Welz K, van Dijk M, Mayse ML, Shah PL, Slebos DJ; BREATHE Study Group. Airway Scaffolds for Emphysema-related Hyperinflation: Six-Month Results from the BREATHE Trial. Am J Respir Crit Care Med. 2025 Jul;211(7):1175-1184. doi: 10.1164/rccm.202502-0378OC.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
3 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Apreo Implant Group in people with Emphysema or COPD, run by Apreo Health, Inc. at 3 sites in 3 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 12 inclusion and 28 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 31 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Austria, Netherlands, United Kingdom. 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. 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?
Rate of Serious Adverse Events (SAE) at 6 Months (time frame: 6 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 NCT05949645, which also lists 1 linked publication.
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 31 Mar 2026.