Lobar Volume Reduction of ≥50% with Zephyr Valves Correlates with Significant Reduction in Longer-term Rate of Severe COPD Exacerbations

<bold>Background:</bold> Improvements in FEV1, 6MWD and SGRQ after BLVR with Zephyr valves (EBV) were shown in the LIBERATE Study. There was a trend towards a reduction in the rate of severe COPD exacerbations (requiring hospitalization) in the longer-term (p=0.053) compared to medically managed Control group (SoC). Absolute improvements after BLVR are higher in patients that achieve a treated lobar volume reduction (TLVR) of ≥50%. <bold>Objectives:</bold> Compare rates of severe COPD exacerbations between the EBV and SoC in the year after treatment using TLVR threshold of ≥50%. <bold>Methods:</bold> Post-hoc analysis of LIBERATE study data for Clinical Events Committee adjudicated severe COPD exacerbations. <bold>Results:</bold> Of the 128 EBV subjects (mean±SD: baseline age, 64.0±6.9yrs; FEV1, 28.0±7.45% pred; RV, 224.5±42.5% pred), 70 subjects achieved ≥50% TLVR at 12months; mean RV reduction of 17.3%. Clinical outcomes at 12months for subjects with TLVR ≥50% were significantly higher and severe COPD exacerbation rate significantly reduced compared to the SoC (n=62) during the 46day to 12month post-EBV period. <fig><object-id>erj;64/suppl_68/OA2799/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> TLVR of ≥50% after BLVR with EBV correlated with significantly fewer severe COPD exacerbations in the longer-term post-valve treatment. The improved clinical outcomes and the reduction in COPD exacerbations resulting in hospitalization has the potential to reduce the economic burden of severe COPD.