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CLINICAL NOTEBOOK 2

CLINICAL NOTEBOOK 2
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CLINICAL NOTEBOOK 2

Product catalog summary
Introduction
Airway clearance techniques (ACTs) are crucial for patients with mucociliary dysfunction, aiding in sputum transport by manipulating lung volumes and pressures. Simeox technology, developed by Physio-Assist, is an innovative ACT designed to mobilize mucus in the distal airways, enhancing expectoration.

Clinical Studies and Findings
Cystic Fibrosis (CF): The SIMETOL study assessed Simeox in adult CF patients, demonstrating safety, feasibility, and good tolerability. The study involved 11 patients and showed improved secretion clearance when Simeox was used alongside conventional physiotherapy. Most patients preferred using Simeox alone or in combination with traditional methods.

Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis: ACTs benefit COPD and bronchiectasis patients by reducing the need for mechanical ventilation during exacerbations and potentially improving quality of life. Simeox targets these conditions by altering mucus rheology and facilitating its movement.

Study Design and Results
A pilot study in Russia compared Simeox to traditional physiotherapy in CF patients, finding no adverse events and demonstrating the feasibility of Simeox in clinical settings. Patients reported ease of use and satisfaction with the device.

Conclusion
Simeox technology is a promising tool for airway clearance in obstructive lung diseases, offering additional benefits in comfort and perceived efficiency. It is well-tolerated and preferred by many patients over traditional physiotherapy methods.
Introduction
This document presents findings from studies on the Simeox device, an innovative ACT, in patients with COPD and Asthma COPD Overlap Syndrome (ACOS). The studies evaluate the effectiveness, safety, and patient usability of the Simeox device compared to manual physiotherapy.

Study Objectives and Methods
The primary objective was to assess the feasibility and effects of the Simeox device in hospitalized COPD patients with chest congestion. The study involved 10 COPD patients divided into two groups: one using the Simeox device and the other undergoing manual physiotherapy. Spirometry, symptoms, and usability were measured over a 5-day period with two 20-minute sessions per day.

Results
Patients using the Simeox device showed significant improvements in mucus clearance and respiratory symptoms. The device group experienced an increase in FEV1 by +0.15±0.10L and an improvement in the CAT score from 20.2±6.4 to 17.0±4.6. No adverse events were reported, and patients quickly became autonomous in using the device.

Comparison with Manual Physiotherapy
Both the Simeox and manual physiotherapy groups showed improvements, but the Simeox group had additional benefits in lung function and quality of life. The device was well-tolerated, with no significant side effects reported.

Conclusions
The Simeox device is a feasible and safe alternative to manual physiotherapy for airway clearance in COPD and ACOS patients. It offers potential benefits in lung function and quality of life, warranting further investigation in larger, randomized studies.

Recommendations
Further studies are recommended to explore the long-term benefits of the Simeox device in a larger patient population. The device's ease of use and effectiveness suggest it could be a valuable tool in managing chronic lung diseases.

References
The document cites various studies and reviews on airway clearance techniques, emphasizing the potential of the Simeox device as an effective alternative to conventional methods.
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Catalog excerpts

CLINICAL NOTEBOOK 2-1

Application of the Simeox airway clearance technology in the treatment of Cystic Fibrosis France | Pr Martine REYNAUD-GAUBERT Oral communication CPLF 2019, Marseille Russia | Pr Alexander AVERYANOV COPD and BRONCHIECTASIS Czech Republic | Pr Vitezslav KOLEK Poland | Pr Pawel SLIWINSKI Late-breaking abstract ERS Paris 2018 Romania | Pr Florin Dumitru MIHALTAN Late-breaking abstract ERS Paris 2018 Slovakia | Associated Pr Ivan SOLOVIC Simeox Clinical Notebook n°2

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CLINICAL NOTEBOOK 2-3

Introduction Airway clearance techniques (ACTs) represent a panel of various techniques performed by the external application of forces to clear bronchial secretions from the lungs1. ACTs facilitate sputum transport via manipulation of lung volumes, gas flow, pulmonary pressures and compressive forces. A combination of these factors exerts shearing forces onto sputum at the air-liquid interface, and the resulting energy transfer shifts secretions towards the mouth. This mechanism is well known as two-phase gas-liquid flow and is considered essential for lung clearance in patients with mucociliary...

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CLINICAL NOTEBOOK 2-5

Cystic Fibrosis Clinical and Scientific Evidences

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Simetol prospective cohort study Evaluating safety, tolerability and efficacy of Simeox compared to usual chest physiotherapy techniques for airway secretion clearance M2P2 Laboratory UMR 7340, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, Marseille and Aix-en-Provence, France Pneumology unit, CRCM adult CHU Nord, APHM-Aix Marseille Université, Marseille, France Oral communication CPLF 2019, Marseille Revue des Maladies Respiratoires, Volume 36, Supplément, 2019 CPLF declines all responsability with respect to the information published in this docume

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CLINICAL NOTEBOOK 2-8

Introduction According to the 2018 standards of cares for Cystic fibrosis (CF), meticulous daily management of lung disease is essential to prevent infection and preserve lung function in CF. However, daily chest physiotherapy may be a burden for patients and relatives and prescription of a suitable airway clearance technique (ACT) should therefore be tailored to patient preference. SIMETOL study aims to assess through a multidisciplinary approach, the feasibility, safety and efficacy of Simeox (PhysioAssist, France) in patients with stable chronic obstructive pulmonary disease and requiring airway...

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CLINICAL NOTEBOOK 2-9

INCLUSION VISIT 4 RESPIRATORY THERAPIST (RT) VISITS: TWICE DAILY SESSION MORNING AFTERNOON VISIT 1 VISIT 2 VISIT 3 VISIT 4 VISIT 5 Results 11 adult CF patients were included in the subgroup analysis. Mean age was 34±9 years, 7 male and 4 women, BMI 19.8±3.2. Mean rate of usual chest physiotherapy session was 31 ±16/month. Baseline PFTs: FEV1 1015±401 ml, FVC 1919±641 ml, FEV1% 31±13%, FEV1/FVC% 52±6%, Median duration of sessions was similar (30 min) between Simeox and usual chest physiotherapy. All patients completed the study. No side effect nor decrease of SpO2 was reported during both interventions....

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CLINICAL NOTEBOOK 2-11

Pilot Safety and Feasibility Study of Simeox Physiotherapy vs. Traditional Physiotherapy in Adult Cystic Fibrosis Patients in Clinical Setting E. AMELINA A. AVERYANOV S.KRASOVSKIY Russian Research Institute of Pulmonology, Mucoviscidosis Laboratory, Moscow, Russia

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CLINICAL NOTEBOOK 2-12

To assess safety and feasibility of Simeox physiotherapy during the pulmonary exacerbation treatment in adult Cystic Fibrosis patients in clinical setting compared to conventional physiotherapy. Materials and Methods Patients. Adult Cystic Fibrosis patients, having an in-patient pulmonary exacerbation treatment were included in prospective, monocentric, randomized controlled study. The Study group was formed of 5 patients randomized to have Simeox (physio-Assist, France) physiotherapy together with standard medical treatment of CF pulmonary exacerbation in pulmonology department. 5 patients were...

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CLINICAL NOTEBOOK 2-13

Format was performed to all Study group patients with a treatment duration of 20 - 25 minutes : 2 sessions per day, 1 morning and 1 evening, for 5 days. Control group patients had traditional manual physiotherapy technique : 2 sessions per day, 1 morning and 1 evening, for 5 days. Results There was no adverse events in both groups during 5-day course of treatment, and no withdrawal from Simeox physiotherapy. Questionnaire results in both groups. Tables 2 - 8 There was no significant difference between the groups in questionnaire results. Table 2 | During the last 2 weeks how difficult it was...

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CLINICAL NOTEBOOK 2-14

Table 3 | During the last 2 weeks how often: 1- You can walk for a long time without fatigue, 2- You can walk for a long time, but you get tired, 3- You can't walk for a long time because you get tired, 4- You refrain from walking, because you get tired quickly. 1- not difficult at all, 2- a bit difficult, 3- moderately difficult, 4- very difficult

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Table 5 | What statement is right for you?

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There was no significant difference between the groups in FEV1 increase as well: +9.0±6.0% pred. in the Study Simeox group and + 8.0 ± 2.9 % pred. in the Control group (р=0.751) (Fig.1) Fig.1 FEV1 changes (%pred) in the Study group (blue) and the Control group (green) after 5-day course of treatment.

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CLINICAL NOTEBOOK 2-18

In the Study (Simeox) group the expectorated sputum volume decrease after 5 days of treatment was significantly lower than the expectorated sputum volume decrease after 5 days of treatment in the Control group that may be related to positive draining effect of Simeox physiotherapy (Fig.2,3). Fig.2| Study group. Expectorated sputum volume decrease (ml) during 5 days of treatment Vol (ml) 120 Fig.3| Control group. Expectorated sputum volume decrease (ml) during 5 days of treatment

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On the Day 1 of treatment the expectorated sputum volume (Med, IQR) in the Study group was -55.0 (50.0) ml, in the Control group -70.0 (22.5) ml. (Table 9). On the Day 5 of treatment the expectorated sputum volume (Med, IQR) was 30.0 (22.5) ml in the study group, in the Control group 20.0 (20.0) ml, p=0.243. The expectorated sputum volume in the Study group decreased 2.0 (0.28) times, it is significantly lower (p=0.034) than in the Control group, where the sputum volume decreased 2.3 (1.25) times. Table 9 | Expectorated sputum volume (ml) in both groups during 5 days of treatment 4-very much...

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