Supplementary Material for: Bronchoscopic Lung Volume Reduction Coil Treatment for Severe Emphysema: A Systematic Review and Meta-Analysis of Individual Participant Data

<b><i>Background:</i></b> Lung volume reduction coil (LVR-coil) treatment provides a minimally invasive treatment option for severe emphysema patients which has been studied in multiple clinical trials. <b><i>Objectives:</i></b> The aim of the study was to assess the effect of LVR-coil treatment on pulmonary function, quality of life, and exercise capacity using individual participant data. <b><i>Method:</i></b> PubMed, Web of Science, and EMBASE were searched until May 17, 2021. Prospective single-arm and randomized controlled trials that evaluated the effect of LVR-coil treatment on forced expiratory volume in 1 s (FEV₁), residual volume (RV), St. George Respiratory Questionnaire (SGRQ) total score, and/or 6-min walk distance (6MWD) and were registered in an official clinical trial database were eligible for inclusion. Individual patient data were requested, and a linear mixed effects model was used to calculate overall treatment effects. <b><i>Results:</i></b> Eight trials were included in the final analysis, representing 680 individual patients. LVR-coil treatment resulted in a significant improvement in FEV1 at 3- (0.09 L [95% confidence interval (95% CI): 0.06–0.12]) and 6-month follow-up (0.07 L [95% CI: 0.03–0.10]), a significant reduction in RV at 3- (−0.45L [95% CI: −0.62 to −0.28]), 6- (−0.33L [95% CI: −0.52 to −0.14]), and 12-month follow-up (−0.36L [95% CI: −0.64 to −0.08]), a significant reduction in SGRQ total score at 3- (−12.3 points [95% CI: −15.8 to −8.8]), 6- (−10.1 points [95% CI: −12.8 to −7.3]), and 12-month follow-up (−9.8 points [95% CI: −15.0 to −4.7]) and a significant increase in 6MWD at 3-month follow-up (38 m [95% CI: 18–58]). <b><i>Conclusions:</i></b> LVR-coil treatment in emphysema patients results in sustained improvements in pulmonary function and quality of life and shorter lived improvements in exercise capacity. Since the owner of this LVR-coil has decided to stop the production and newer generations LVR-coils are currently being developed, these results can act as a reference for future studies and clinical guidance.

**背景：** 肺减容线圈（Lung Volume Reduction Coil, LVR-coil）治疗为重度肺气肿患者提供了一种微创治疗选择，该疗法已在多项临床试验中得到研究。
**目的：** 本研究旨在利用个体受试者数据，评估LVR-coil治疗对肺功能、生活质量及运动能力的影响。
**方法：** 检索截至2021年5月17日收录于PubMed、Web of Science及EMBASE的文献。纳入标准为：评估LVR-coil治疗对1秒用力呼气容积（forced expiratory volume in 1 s, FEV₁）、残气量（residual volume, RV）、圣乔治呼吸问卷（St. George Respiratory Questionnaire, SGRQ）总分及/或6分钟步行距离（6-min walk distance, 6MWD）影响的前瞻性单臂试验及随机对照试验，且此类试验已在官方临床试验数据库完成注册。研究团队申请获取个体患者数据，并采用线性混合效应模型计算总体治疗效应。
**结果：** 最终共纳入8项试验，涉及680例个体患者。LVR-coil治疗可使患者在随访3个月（0.09 L，95%置信区间[95%CI]：0.06~0.12）及6个月时的FEV₁显著改善（0.07 L，95%CI：0.03~0.10）；在随访3个月（−0.45 L，95%CI：−0.62~−0.28）、6个月（−0.33 L，95%CI：−0.52~−0.14）及12个月时的RV显著降低；在随访3个月（−12.3分，95%CI：−15.8~−8.8）、6个月（−10.1分，95%CI：−12.8~−7.3）及12个月时的SGRQ总分显著降低；且在随访3个月时的6MWD显著提升（38 m，95%CI：18~58）。
**结论：** 肺气肿患者接受LVR-coil治疗后，肺功能与生活质量可获得持续改善，而运动能力的改善则持续时间较短。鉴于该款LVR-coil的生产商已决定停产，且新一代LVR-coil目前正处于研发阶段，本研究结果可为未来相关研究及临床实践提供参考依据。