Introduction

Asthma COPD Overlap Syndrome (ACOS) is a COPD phenotype with worse prognosis. Airway clearance techniques (ACTs) may

improve symptoms and reduce hospitalization and exacerbation in COPD and ACOS but need to be evaluated.

Aim

Aim of our monocentric study was to assess feasibility and effects of an innovative ACT (Simeox, Physio-Assist, France) in

COPD/ACOS with chest congestion despite adherent medication and conventional physiotherapy.

Patients were included from 13 March to 23 April 2018.

Methods

Primary endpoint was ability to properly use the device as evaluated by patient preference.

Secondary endpoints were safety, tolerance, patients reported outcomes, changes in mucus production, spirometry and ABG.

Inclusion criteria were: age >18yr, COPD or overlap COPD-asthma (ACOS), patient reporting symptoms of excessive mucus and

difficulties to clear the mucus despite conventional manual physiotherapy technique performed by the physiotherapist.

Simeox device training was performed after patient inclusion. Patient had usually one daily Simeox session for 6 days.

Blood gases and acid-base balance were assessed before and after each session. 3 successive programs were performed during

each session: Program 1: 6 expiratory cycles, Program 2: 8 expiratory cycles and Program 3: 10 expiratory cycles. Power selection

was 25 or 50%. Expectoration were monitored by clinical team during each session and the patient monitored himself the

expectoration after the session.

Results

15 COPD/ACOS patients hospitalized for AECOPD who reported symptoms of excessive mucus congestion were treated with

Simeox device. The duration of clearance therapy session with Simeox was between 15-25 min.

Age was 67.9±10.5, 10 men and 5 women, 10 COPD and 5 ACOS, 8 GOLD 3-4, 13 very symptomatic (GOLD B/D) and 11 with high

risk (GOLD C/D). 5 had LABA/LAMA and 7 had ICS/LABA/LAMA (Table 1).

Patients were able to use the device after a 15-min of training during the first session. No adverse event nor pain was reported.

Mucus clearance was improved (++/+++) in all patients compared to previous manual physiotherapy (Table 1). Pa02 increased by

+ 0.4-1.4 kPa. FEV1 improved by +200±56 ml and +142±29 ml in COPD and ACOS, respectively. In the patients GOLD 3-4, FEV1

improved by +158±30 ml

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