There was no improvement in the percent of predicted forced vital capacity (FVC) in boys with Duchenne muscular dystrophy (DMD) who practiced twice-daily lung volume recruitment (LVR) vs those who did not, according to a new study published in Thorax.

“We found no difference in FVC % predicted at 2 years of follow-up among boys with DMD and relatively normal baseline pulmonary function using twice-daily LVR in addition to usual care compared with usual care alone,” the researchers wrote. “This may be because the expected loss of FVC % predicted over a 2-year period is small in those with relatively normal lung function at baseline.”

The study cohort was a multicenter randomized trial conducted on 66 boys with DMD aged 6 to 16 years. Boys with baseline FVC from >30% to ≥80% predicted were included to assess the impact of LVR across a range of disease severity.


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The results showing no change in the percent of predicted FVC suggest that LVR offers less benefit to boys with less advanced disease, given that many of the participants had relatively normal lung function at baseline. This new evidence means that the additional treatment burden of LVR might not be necessary for those patients with relatively normal lung function.

The results represent a useful contribution to current clinical guidelines, particularly because compliance with LVR is typically low, at around 40%. However, the researchers caution that LVR still might play an important role in airway clearance during exacerbations and that LVR might contribute to the maintenance of normal lung function in these patients.

Furthermore, LVR might be more beneficial in boys with poorer baseline lung function and more advanced disease, and the authors recommend further studies to address this question.

Reference

Katz SL, Mah JK, McMillan HJ, et al. Routine lung volume recruitment in boys with Duchenne muscular dystrophy: a randomised clinical trial. Thorax. Published online March 2, 2022. doi:10.1136/thoraxjnl-2021-218196