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Patients and providers are increasingly exploring treatment options for managing chronic respiratory conditions like bronchiectasis and cystic fibrosis. Two of these approaches: vest therapy (also known as high-frequency chest wall oscillation, or HFCWO) and DPP1 inhibitors (dipeptidyl peptidase 1 inhibitors) offer different ways to support airway health and interrupt the compounding of symptoms, otherwise known as the vicious vortex.
In this article, we’ll look at how pharmaceutical and non-pharmaceutical options compare.
Learn more about the vicious vortex.
What Are DPP1 Inhibitors?
DPP1 inhibitors are a newer class of drugs in testing to treat specific respiratory conditions. These oral medications work by suppressing the activity of neutrophil serine proteases (NSPs), such as neutrophil elastase, which can contribute to lung tissue damage in diseases like bronchiectasis. A DPP1 inhibitor aims to reduce inflammation and slow disease progression by modulating the immune response.1
What is Vest Therapy?
Since the 1980s, vest therapy has been a reliable part of treatment for those with chronic mucus buildup. These airway clearance devices deliver gentle, rapid oscillations to the chest wall, helping loosen and mobilize mucus from the lungs. This physical method supports the body’s natural airway clearance process. It’s non-invasive, drug-free, and often used daily at home to improve breathing and reduce infections.
The SmartVest Airway Clearance System is one such device, offering comfortable, easy-to-use therapy designed to fit right into your daily life. In a published study, patients who used SmartVest experienced a dramatic improvement in their breathing and lung function and even saw a decrease in antibiotic usage.2
Therapy with SmartVest significantly decreases exacerbations requiring hospitalization and antibiotic use, and stabilizes lung function.3
Key Differences Between These Two Approaches
- How They Work. Vest therapy focuses on the physical clearance of mucus. For individuals with chronic respiratory conditions, effective mucus clearance is a cornerstone to treatment approaches and can help prevent infections. Conversely, DPP1 inhibitors act on the biochemical pathways that drive inflammation.
- What Their Goals Are. Vest therapy is designed to help mobilize and expel mucus. When mucus remains in the lungs, it can create an environment for bacteria to grow, often leading to exacerbations, also known as flare-ups. Meanwhile, DPP1 inhibitor drugs are intended to alter disease progression at the cellular level, often leading to a merry-go-round of infection, medication use, and lung damage. Airway Clearance is first-line therapy in stopping the cycle. Experts recommend a comprehensive strategy that combines airway clearance therapy and DPP1 inhibitors.4
- What Their Side Effects Include. While airway clearance devices tend not to have systemic side effects, it remains to be seen what side effects or contraindications will come with this pharmaceutical approach.
The Takeaway: Clear Airways First
HFCWO therapy, including SmartVest, can be used for a wide range of chronic lung conditions characterized by mucus buildup, including bronchiectasis and cystic fibrosis. Vest therapy is a more broadly applicable and non-pharmaceutical approach for managing long-term respiratory health.
While DPP1 inhibitors represent possibilities, airway clearance remains a proven, non-invasive solution for patients with chronic mucus buildup. As always, treatment decisions should be guided by a healthcare provider and tailored to each patient’s specific condition and needs.
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Comprehensive Symptom Management
While these two treatments are different from one another, they can work together. Combining airway clearance with potential future pharmacologic options may help manage chronic respiratory conditions and reduce the risk of flare-ups.
Find the Approach That Works for You 
Dealing with a chronic respiratory condition comes down to what solution works best for you. Want to understand more about SmartVest and how it can fit into your daily routine? Request our information packet, and we’ll deliver it right to your door. Let’s see how we can help you start breathing easier.
Resources
- National Library of Medicine. “Dipeptidyl peptidase 1 inhibition as a potential therapeutic approach in neutrophil-mediated inflammatory disease.” Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10755895/
- Sievert C et al. Respiratory Therapy, Vol. 11 No 4, 34-38, 2016.
- Powner J, et al. Employment of an algorithm of care including chest physiotherapy results in reduced hospitalizations and stability of lung function in bronchiectasis. BMC Pulmonary Medicine. 2019;19(82).
- National Library of Medicine. “Dipeptidyl peptidase 1 inhibition as a potential therapeutic approach in neutrophil-mediated inflammatory disease.” Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10755895/
