Simeox 200 US Study

A Pilot Study to Assess the Effects of Simeox 200 Airway Clearance Device in Bronchiectasis Patients With Chronic Mucus Hypersecretion

The purpose of this single arm post-market observational study is to evaluate the short-term effectiveness of the Simeox 200 airway clearance device in improving airway clearance in adult patients aged 18 to 85 with bronchiectasis and chronic mucus hypersecretion. The study aims to establish a baseline for wet sputum weight production using the Simeox 200 device. Additionally, the study aims to assess the short-term effects of Simeox 200 on various outcomes, including lung function, respiratory symptoms, and health-related quality of life.

The study participants will undergo the following steps:

1. Baseline Visit (V0): Participants will attend a baseline visit for eligibility screening, consent, a physical exam, and baseline assessments of various relevant parameters such as lung function, SpO2, and Patient-Reported-Outcomes.
2. Treatment Sessions (V1): Participants will perform two supervised treatment sessions with the Simeox 200 device at the clinic, during which sputum will be collected and weighed.
3. Home Use : Participants will use the device at home twice daily for 2 weeks, recording their usage and symptoms in a daily electronic diary.
4. Final Clinic Visit (V2): Participants will return for a final clinic visit for repeat assessments.
5. Follow-up Phone Call (14 days after V2): Participants will receive a follow-up phone call to assess ongoing symptoms and health status.

Airway clearance techniques (ACTs) are essential for removing excess bronchial secretions and preventing airway complications. However, their effectiveness relies on patient adherence and satisfaction. Simoex 200 is a novel airway clearance device that uses intermittent negative oscillating pressure to mobilize airway secretions from different parts of the lungs to central airways, facilitating expectoration. Preliminary studies in Europe on patients with chronic muco-obstructive lung diseases have demonstrated the effectiveness and good tolerance of previous generations of the device. This pilot study will evaluate the Simeox 200 device in a home care setting for patients with bronchiectasis and excessive mucus production. The results of this study will inform a future larger-scale clinical trial.

Inclusion Criteria:

1. Diagnosis of bronchiectasis confirmed by computed chest tomography (CT chest) performed within the prior 36 months
2. Persistent productive cough for which daily airway clearance therapy is prescribed.
3. Daily sputum production estimated at > 1 tsp or 5 ml
4. Clinically stable on medical regimen with no pulmonary exacerbation in the past 4 weeks prior to study enrolment
5. Subject able to sign informed consent

Exclusion Criteria:

1. Inability to cough forcefully and independently, as determined by the clinician
2. Ventilatory assistance with endotracheal tube, tracheostomy tube, or mask (not including nocturnal CPAP)
3. Neuromuscular disease with muscle respiratory weakness
4. Severe restrictive lung disease defined as Forced Vital Capacity (FVC) <60% of predicted
5. Unstable cardiac disease (e.g. major cardiac arrhythmia, unstable heart failure, heart attack, unstable angina)
6. Hemodynamic instability, as determined by the clinician
7. Airway at risk for aspiration, as determined by the clinician
8. Uncontrolled gastroesophageal reflux disease (GERD) as determined by the clinician
9. Upper airway surgery in the prior 3 months
10. Cardiothoracic surgery, including esophageal surgery, in the prior 6 months
11. Anticipated hospitalization within the next 2 weeks
12. History of pneumothorax within the prior 6 months
13. History of haemoptysis treated with embolization within the prior 12 months
14. Inability to use airway clearance therapy as directed
15. Unable or unwilling to complete study visits or provide follow-up data as required per the study protocol
16. Pregnant or lactating female