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This a 70 patient multi-site non blinded randomized control trial evaluating the use of the Vest® System for treatment of Non-Cystic Fibrosis Bronchiectasis (NCFBE) patients in the home setting. The study will assess outcomes in subjects requiring airway clearance therapy randomized to Oscillating Positive Expiratory Pressure (OPEP) therapy as the control group and High Frequency Chest Wall Oscillation (HFCWO) therapy as the intervention group
Patients with NCFBE who require regular home airway clearance therapy will be eligible to be screened for inclusion in the study.
After enrollment, baseline data including demographics, pulmonary related medical history including acute exacerbations (pulmonary-related hospitalizations, ED visits and physician office visits) will be collected Pulmonary function tests (PFTs) (spirometry), and a six-minute walk test will be completed. Quality of Life measures and inflammatory markers and will be collected.
Patients will be randomized to HFCWO or OPEP therapy. Each device will be used within the approved product labeling. These will be the primary airway clearance devices for these patients during the 12 months of the study period.
Following enrollment in the study and completion of a baseline visit, subjects will be seen for follow-up visits.
Detailed documentation of health status and medical history will be collected during the 12-month study period and/or at each study visit to document the occurrence of acute exacerbations and to determine time to first exacerbation, number of hospitalizations and hospitalization days, number of ICU admissions and ICU days, and number of outpatient visits (Physician's office visit, Urgent Care Visits, ED visits)
At 3 months, 6 months and 12 months following the baseline visit, the following tests/procedures will be performed. At each follow-up study visit:
Mean adherence to the prescribed treatment regimen will be collected and assessed using the validated Modified Self-Reported Medication-Taking Scale. Adherence data in the HFCWO arm will also be collected via the VisiView patient portal.
Adherence results will be collected at the 3-month visit, 6-month visit and 12-month visits.
Any device related adverse events which occur after initial therapy with The Vest® System or Acapella therapy will be recorded.
Any equipment related complaints which occur after initial therapy with The Vest® System or Acapella therapy will be recorded.
At the end of the 12-month study period, all subjects will be given the option of receiving HFCWO therapy for additional 6 month follow up period with outcomes data assessed at the 15-month and 18-month (from baseline visit) time points.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HFCWO group | Active Comparator | Subjects in this arm of treatment will use The Vest® as their primary airway clearance modality for the duration of the study. |
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| OPEP group | Active Comparator | Subjects in this arm of treatment will use the Acapella® as their primary airway clearance modality for the duration of the study. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High Frequency Chest Wall Oscillation | Device | High frequency chest wall oscillation (HFCWO) therapy (also known as high-frequency chest-wall compression or HFCWC) is commonly prescribed to provide routine airway clearance in patients with bronchiectasis as well as other patients with a need for regular airway clearance therapy. HFCWO generates high velocity expiratory airflow. This airflow is thought to mobilize secretions by the sheer force created, effecting changes in rheology and moving mucus in a cephalad direction during the oscillation. The Vest® Airway Clearance System, a commonly used device, generates HFCWO using an air pulse generator and an inflatable garment that delivers pressure pulses to the thorax. These pressure pulses within the garment create HFCWO. |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of acute exacerbations of bronchiectasis | Acute exacerbation periods will be defined as per the European Respiratory Society consensus definition:
| 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| 6-minute walk test | The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise. It will provide information regarding functional capacity and response to therapy. | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ashwin Basavaraj, MD | NYU Langone Health | Principal Investigator |
| Clyde Southwell, MD | Tennessee Comprehensive Lung and Sleep Center | Principal Investigator |
| Julie Philley, MD | University of Texas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NYU Langone Health | New York | New York | 10016 | United States | ||
| Tennessee Comprehensive Lung and Sleep Center |
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The study will be a non-blinded prospective Randomized Control Trial (RCT) pilot study with subjects requiring airway clearance therapy randomized to Oscillating Positive Expiratory Pressure (OPEP) therapy as the control group and High Frequency Chest Wall Oscillation (HFCWO) therapy as the intervention group
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| Oscillating Positive Expiratory Pressure (OPEP) | Device | Oscillating PEP is an airway clearance technique, where the person blows all the way out many times through a device. These types of oscillating PEP devices work in two ways. Firstly, they use resistance to make it more difficult during the breath out, like non-oscillating PEP devices. Oscillating PEP devices also create vibrations when breathing out. The vibrations move mucus from the surface of the airways. After blowing through the device several times, the person will huff and cough to clear the mucus from the lungs. |
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| Pulmonary function tests | FVC, FEV1 and FEV1/FVC as indicators of pulmonary function will be assessed using standard spirometry | 12 months |
| Quality of life measure using the Quality of Life - Bronchiectasis (QoL-B) tool | The Quality of Life-Bronchiectasis (QoL-B), a self-administered, patient-reported outcome measure assessing symptoms, functioning and health-related quality of life for patients with NCFBE, contains 37 items on 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden) | 12 months |
| Time to first exacerbation | The duration of time from initiation of therapy to occurrence of an episode of acute exacerbation of bronchiectasis | 12 months |
| Number of exacerbation related hospitalizations | This is the total number of times the subject was admitted as an inpatient due to symptoms of an acute exacerbation | 12 months |
| Number of exacerbation related inpatient hospital days | This is the total number of days the subject spent in an inpatient non-ICU setting due to symptoms of an acute exacerbation | 12 months |
| Number of exacerbation related ICU admissions | This is the total number of times the subject got admitted into an ICU facility due to symptoms of an acute exacerbation | 12 months |
| Number of exacerbation related ICU days | This is the total number of days the subject spent in an ICU due to symptoms of an acute exacerbation | 12 months |
| Number of exacerbation related outpatient visits (Physician's office, Urgent Care Visits, ED visits) | This is the total number of times the subject visited an outpatient healthcare facility due to symptoms of an acute exacerbation | 12 months |
| Number of courses of antibiotics during episodes of acute exacerbation | This is the total courses of antibiotics prescribed for acute exacerbations | 12 months |
| Number of antibiotic use days during episodes of acute exacerbation | This is the total number of days spent on antibiotics for acute exacerbations | 12 months |
| Mean adherence to prescribed treatment regimen | Adherence data will be collected using the Modified Self-Reported Medication Taking Scale and verified via the VisiView patient portal | 12 months |
| Bronchiectasis related medication | Bronchiectasis related medication data will be collected from subject's electronic medical chart | 12 months |
| Nashville |
| Tennessee |
| 37075 |
| United States |
| UT Tyler Health Science Center | Tyler | Texas | 75708 | United States |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 15, 2025 | Jan 5, 2026 | 5 | ||
| Mar 6, 2026 | Mar 25, 2026 | 6 | ||
| Apr 1, 2026 | Apr 21, 2026 | 7 |
| ID | Term |
|---|---|
| D001987 | Bronchiectasis |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D035641 | Chest Wall Oscillation |
| ID | Term |
|---|---|
| D012138 | Respiratory Therapy |
| D013812 | Therapeutics |
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