ClinicalTrials.gg
RecruitingNCT06891755BREATHE-3Updated Oct 19, 2026

Bronchoscopic RElease of Air Trapped in Hyperinflated Emphysematous Lung - Study 3

An interventional study of Apreo BREATHE Airway Scaffold and Optimal Medical Management (OMM) in COPD and Emphysema, sponsored by Apreo Health, Inc.. Recruiting at 23 sites in 5 countries. Open to participants aged 40 Years to 84 Years. Per ClinicalTrials.gov, last updated 2026-10-19.

Sponsored by Apreo Health, Inc. · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2025; still recruiting 1 year 3 months later.
Updated Oct 19, 2026First site in Germany2 sites added+1 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
40 Years to 84 Years
Sex
All
01

Study summary

The objective of this study is to assess the safety and efficacy of Apreo BREATHE system when used to support native airways and release trapped air in the treatment of adult COPD patients with emphysema suffering from dyspnea due to hyperinflation despite optimal medical treatment. The Apreo BREATHE Airway Scaffold is a permanent implant designed to tent open native airways. The study will include up to 250 participants at up to 25 study centers located in the United States and Europe. Study subjects will be followed for 3 years. The main questions it aims to answer are: Is it safe? Does it work?

Read the detailed description

Prospective, randomized, two arm, parallel group, concurrently controlled, open-label, multi-center clinical trial following up to 250 participants to 3 years.

Each site will participate in a Roll-In phase prior to participation in the randomized phase of the study. Each site will enroll up to 2 subjects in this phase. Up to 50 subjects may be enrolled into the Roll-In cohort.

Up to 200 subjects with bilateral emphysema will be randomized at up to 25 centers in the United States centers and Europe.

In the Randomized cohort, subjects will be randomized to either a Treatment or Control group in a 2:1 ratio.

  • Optimal Medical Management: All subjects (Roll-in and Randomized) will receive optimal medical management tailored to patient needs and per standard of care and as outlined in the 2024 GOLD report. This may include smoking cessation, vaccination, long-acting bronchodilator therapy, corticosteroids (when appropriate), and participation in or maintenance of an exercise program or pulmonary rehabilitation program.
  • Treatment group: 133 subjects will receive optimal medical management and Apreo Implant placements. Treatment group subjects will undergo a single bronchoscopy with bilateral placement of up to 3 implants per lung in appropriately selected target airways. Appropriate target segments shall be based on segmental and lobar information (i.e. airway dimensional, emphysematous destruction, volumetric information, hetero/homogeneity) provided in the Quantitative CT (QCT) report for each patient.
  • Control group: 67 subjects will receive optimal medical management. Control group subjects will be allowed the opportunity to cross over and receive the BREATHE treatment after their Month 12 visit and within 15 months from their baseline visit.

Subjects will undergo follow-up assessments at Months 1, 3, 6 and 12, and Years 2 and 3 post-procedure (treatment group) or post-randomization (control group). These visits will involve adverse event assessment, questionnaires, pulmonary function testing, and inspiratory/ expiratory CT scans.

Control group subjects electing crossover will then have additional follow-ups at 7- and 30-days post procedure, and 6 months post procedure. Control group subjects not electing crossover will be exited from the study after Month 12.

02

Conditions studied

  • COPD
  • Emphysema

Keywords

  • Apreo
  • COPD
  • Emphysema
  • BREATHE System
  • Hyperinflation
  • Air-trapping
  • Apreo BREATHE Airway Scaffold
  • BREATHE Implant
  • Airway Scaffold
  • Apreo Health
03

In context

Pulmonary Disease, Chronic Obstructive

5,520 studies on the registry are indexed under Pulmonary Disease, Chronic Obstructive; 856 are open to participants now.

This study's planned enrollment of 250 is above the median of 62 across 3,839 interventional studies indexed under Pulmonary Disease, Chronic Obstructive.

Browse Pulmonary Disease, Chronic Obstructive studies →

Lead sponsor

Apreo Health, Inc. is the lead sponsor of 4 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years to 84 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Subject is at least 40, but not older than 84, years of age.

    1. Subject has (BMI) of between 18 and 32, inclusive.
    2. Subject has completed a documented pulmonary rehabilitation program within 12 months prior to Baseline.
    3. Subject has mMRC score ≥ 2.
    4. Subject can walk ≥100 meters in 6 minutes.
    5. Subject has ≥25% emphysema destruction score in each lung as quantified on baseline HRCT scan (low attenuation area less than -950HU) as determined by the CT core lab.
    6. Subject has homogeneous or heterogeneous emphysema, and at least one lung has a 15% difference between upper and lower lobes in emphysema destruction score (-910HU) as determined by the CT core lab.
    7. Subject has bilateral heterogenous emphysema and pre-procedure post-bronchodilator RV ≥ 180% predicted, or one lung with homogenous emphysema and pre-procedure postbronchodilator RV ≥ 200% predicted.
    8. Subject has pre-procedure post-bronchodilator / FVC \< 0.70.
    9. Subject has a pre-procedure post-bronchodilator FEV1 percent predicted of ≥15% and ≤45%.
    10. Subject has pre-procedure post-bronchodilator RV/TLC ≥ 0.55.
    11. Subject has pre-procedure DLCO ≥ 20%.
    12. Subject has been receiving optimal medical management tailored to subject needs for 2 months prior to enrollment.
    13. Subject has not actively smoked (including tobacco, marijuana, e-cigarettes, vaping, etc.) within the last 4 months, and agrees to smoking cessation during the study.
    14. Subject has received preventative vaccinations (or documented clinical intolerance) against potential respiratory infections, including pneumococcus, influenza, RSV (subjects >60 yrs. old) and Covid-19, consistent with local recommendations or policy.
    15. In the opinion of the Primary investigator, subject can undergo bronchoscopy under general anesthesia and is able to adhere to the study follow-up schedule.
    16. Subject has provided written .

Exclusion criteria

  1. Subject has known unresolved lower respiratory tract infection (e.g., pneumonia, mycobacterium avium-intracellulare infection (MAI), fungus, tuberculosis).

    1. Subject has a -dependent condition requiring (e.g. ≥10 mg oral corticosteroid per day).
    2. Subject has bilateral lobar emphysematous destruction scores of >70% percent of voxels with \<-950 Hounsfield units on thin slice inspiratory CT, as determined by the CT core lab.
    3. Subject has arterial or capillary blood on room air: PaCO2 > 50 mmHg (8 kPa) or PaO2 ≤ 45 mmHg (6 kPa).
    4. Subject has had ≥2 hospitalization for acute exacerbations of or ≥3 moderate exacerbations/respiratory infections in the year prior to enrollment.
    5. Subject has had previous lung volume reduction surgery, lobectomy, pneumonectomy, segmentectomy, bullectomy, lung transplantation, vapor, glue, or other pulmonary device implant (unless the device has been removed at least 3 months prior to consent).
    6. Subject has known or suspected history of pulmonary arterial hypertension (e.g. PASP > 50mmHg on echocardiogram in absence of confirmation on a right heart catheterization or mPAP > 25mmHg on a right heart catheterization).
    7. Subject has presence of a giant bulla (≥ 30% of hemithorax).
    8. Subject has significant symptom burden due to currently active adult asthma based on GINA criteria and/or chronic bronchitis as their primary diagnosis.
    9. Subject has presence of suspicious radiological abnormalities on HRCT scan such as pulmonary nodule/infiltrate that in judgement of the PI, may require intervention during course of the study.
    10. Subject has bronchiectasis (>4 TBS / 45mL mucus production/day, per subject estimate) influencing subject's COPD symptoms.
    11. Subject has unresolved lung cancer.
    12. Subject has a serious medical condition that, in the Primary investigator's opinion, could compromise patient safety or confound the interpretation of the patient's response to therapy (e.g., congestive heart failure, cardiomyopathy (documented ≤40%), or myocardial infarction in the past year, renal failure, liver disease cerebrovascular accident within the past 6 months, uncontrolled diabetes ( >8%), uncontrolled hypertension (diastolic BP >110 mmHg or systolic >200 mmHg) or disease requiring treatment with medications or a disease requiring chemotherapy.
    13. Subject is on anticoagulant or antiplatelet therapy for cardiovascular indications and, at the discretion of the Primary investigator, is unable to have anticoagulants withheld for a bronchoscopy procedure per institution's standard of care.
    14. Subject has invasive mechanical ventilator dependency.
    15. Subject is pregnant, lactating, or of and plans to become pregnant during study duration.
    16. Subject has known to Nitinol (nickel-titanium alloy) or its constituent metals (nickel or titanium).
    17. Subject is significantly immunocompromised, such as organ transplant recipients, those with congenital immune deficiencies, AIDS, or severe rheumatoid arthritis.
    18. Subject has sensitivity or allergy to medications necessary for bronchoscopy under general anesthesia.
    19. Subject is currently participating in another study involving an product that could confound the study results or affect the subject's COPD symptoms.
    20. Subject has within the 2 years prior to consent, had a severe respiratory infection with SARS-CoV-2 (COVID-19) that required ICU support with non-invasive and/or invasive mechanical ventilation.
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    Apreo implants + Optimal Medical Management

    Treatment group participants will receive optimal medical management and will undergo a single bronchoscopy with bilateral placement of up to 3 implants per lung in appropriately selected targeted airways.

    Device: Apreo BREATHE Airway Scaffold

  • Other
    Optimal Medical Management

    Control group participants will receive optimal medical management tailored to patient needs and per standard of care and as outlined in the 2024 GOLD report. This may include smoking cessation, vaccination, long-acting bronchodilator therapy, corticosteroids (when appropriate), and participation in or maintenance of an exercise program or pulmonary rehabilitation program.

    Other: Optimal Medical Management (OMM)

Interventions

  • DeviceApreo BREATHE Airway Scaffold

    The experimental treatment involves placement of up to 6 Apreo BREATHE Airway Scaffolds (up to 3 per lung), in a single procedure using bronchoscopy and fluoroscopy. Treatment group subjects will also receive optimal medical management (OMM).

  • OtherOptimal Medical Management (OMM)

    Subjects will receive optimal medical management tailored to patient needs and per standard of care and as outlined in the 2024 GOLD report. This may include smoking cessation, vaccination, long-acting bronchodilator therapy, corticosteroids (when appropriate), and participation in or maintenance of an exercise program or pulmonary rehabilitation program.

06

What researchers measure

Primary outcomes

  1. Forced Expiratory Volume in 1 second (FEV1) Responder

    Defined as a subject who experiences a reduction from baseline in post-bronchodilator FEV1 of ≥12%

    Time frame: Month 12

Secondary outcomes

  1. Residual Volume (RV) + St George's Respiratory Questionnaire for COPD (SGRQ-C)

    Responder rate

    Time frame: Months 3 and 12

  2. St. George's Respiratory Questionnaire for COPD (SGRQ-C) Responder Rate

    SGRQ-C total score

    Time frame: Months 3, 6, 12 and Years 2, 3

  3. Modified Medical Research Council (mMRC) Responder Rate

    mMRC dyspnea score

    Time frame: Months 3, 6, 12 and Years 2, 3

  4. COPD Assessment Test (CAT) Responder Rate

    CAT Score

    Time frame: Months 3, 6, 12 and Years 2, 3

  5. Forced Expiratory Volume in the first second (FEV1) Responder Rate

    FEV1

    Time frame: Months 3, 6, 12 and Years 2, 3

  6. 6-minute walk distance (6MWD)

    6MWD

    Time frame: Months 3, 6, 12 and Years 2, 3

  7. Ratio of residual volume (RV)/ total lung capacity (TLC) Responder Rate

    Ratio RV/TLC

    Time frame: Months 3, 6, 12 and Years 2, 3

  8. Residual Volume (RV) Responder Rate

    RV

    Time frame: Months 3, 6, 12 and Years 2, 3

  9. Forced Vital Capacity (FVC) Responder Rate

    FVC

    Time frame: Months 3, 6, 12 and Years 2, 3

07

Study locations

23 of 23 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Sites
2 sites added, 1 site removed — first site in Germany
Show 2 added (1 United States, 1 Germany)
  • Mayo Clinic · Jascksonville, United States
  • Thoraxklinik Heidelberg · Heidelberg, Germany
Show 1 removed
  • Mayo Clinic · Jacksonville, United States
Oct 19, 2026
Site contacts
Changed at 4 sites. See the sites
Show 4 sites
  • University of Alabama at Birmingham · Birmingham, United StatesContact none listed→•••0950Contact removed e•••@uabmc.edu · •••5294
  • Houston Methodist/Primary Critical Care · Houston, United StatesContact b•••@houstonmethodist.org · •••3248→m•••@houstonmethodist.org · •••4511
  • Medical College of Wisconsin · Milwaukee, United StatesContact s•••@mcw.edu→a•••@mcw.edu · •••6839
  • Royal Brompton Hospital · London, United KingdomContact a•••@nhs.net→j•••@nhs.net
Oct 19, 2026
Show all 1 update
  1. Oct 19, 2026
    2 sites added, 1 site removed — first site in Germany
    Show 2 added (1 United States, 1 Germany)
    • Mayo Clinic · Jascksonville, United States
    • Thoraxklinik Heidelberg · Heidelberg, Germany
    Show 1 removed
    • Mayo Clinic · Jacksonville, United States
    Site contacts Changed at 4 sites. See the sites
    Show 4 sites
    • University of Alabama at Birmingham · Birmingham, United StatesContact none listed→•••0950Contact removed e•••@uabmc.edu · •••5294
    • Houston Methodist/Primary Critical Care · Houston, United StatesContact b•••@houstonmethodist.org · •••3248→m•••@houstonmethodist.org · •••4511
    • Medical College of Wisconsin · Milwaukee, United StatesContact s•••@mcw.edu→a•••@mcw.edu · •••6839
    • Royal Brompton Hospital · London, United KingdomContact a•••@nhs.net→j•••@nhs.net
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06891755
Lead sponsor
Apreo Health, Inc.
Responsible party
Sponsor
First posted
Mar 24, 2025
Start date
Jul 15, 2025
Primary completion
Sep 30, 2027 (estimated)
Completion
Dec 31, 2029 (estimated)
Last update
Oct 19, 2026

Study contacts

Cindy Holtz
Contact
cindy.holtz@apreohealth.com
650-326-2656
Nina Mohmood
Contact
nina.mohmood@apreohealth.com
Gerard Criner, MD
principal investigator · Temple University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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