WS03.01Functional and clinical effect of intermittent intrapulmonary deflation versus autogenic drainage for airway clearance in cystic fibrosis: the MUCOSIM trial

Abstract

Objectives

Improving mucus clearance remains an important aim in cystic fibrosis (CF), and was particularly critical before the widespread availability of high efficiency modulator therapy. Aim of MUCOSIM study was to evaluate the short term functional and clinical impact of instrumental airway clearance by intermittent intrapulmonary deflation (IID) with the Simeox® device (Physioassist), in comparison with the reference autogenic drainage (AD) technique in adult people with CF (pwCF), in stable condition.

Methods

IID with Simeox® and AD were compared in 31 adult pwCF with a crossover application of 4 sessions (3 training sessions and the 4^th one supervised) for each technique performed within 2 weeks, with a 7 days washout between sequences. Oscillometry (Tremoflo, Thorasys) was performed before and after each individual session. Primary endpoint was the comparison of R5 (resistance at 5 Hz) just before and 30 min after the 4th supervised session of each technique. Secondary oscillometric parameters were R20 (resistance at 20 Hz), R5-R20, reactance at 5 Hz (X5), area under the curve of reactance (AX). Spirometry was also performed before and after the 4^th session. Clinical impact of each session was assessed by a visual analog scale (VAS) for dyspnea (VAS dyspnea), perceived bronchial congestion (VAS congestion) and fatigue (VAS fatigue).

Results

No significant difference appeared between groups:

Conclusion

Despite the use of sensitive oscillometry parameters, no impact on lung function was found with both techniques after a single session of AD or IID. A subjective improvement of bronchial congestion post session was found with both techniques. Longer term studies could provide more significant results.