This month, the National Institutes of Health issued termination notices for many research projects at Harvard, including mine.   

My study, called the Air Purification for Eosinophilic COPD Study (APECS), is a multi-year clinical trial that began in 2020. It focuses on people living with eosinophilic chronic obstructive pulmonary disease (COPD) – a more inflammatory form of an already serious, incurable lung disease that affects around 15% of adults over age 40 in the United States. COPD makes everyday activities like walking or climbing stairs incredibly hard. And it’s made worse by something we all breathe every day: air pollution. 

There are medications that help people with eosinophilic COPD, but they can be costly and come with side effects. My team set out to answer a simple but important question: Could HEPA air purifiers – affordable devices already found in many homes – help people with this disease breathe a little easier by removing noxious particles from the indoor air?     

These high-efficiency filters are already known to remove fine particulate matter pollution from traffic and other sources that enters the home, pollen, mold, and pathogens – things that are known to make lung disease and inflammation worse. HEPA filters have been helpful for people with allergic asthma, but they’ve never been tested in people with eosinophilic COPD.  

The results of this trial could give doctors and patients a low-risk, non-drug strategy to improve respiratory health. That’s especially important given the growing concerns about climate change and air quality. And if the evidence supports their use, HEPA filters could be covered by medical insurance as durable medical equipment, much like supplemental oxygen or nebulizer machines. 

The study: Air purification for eosinophilic COPD study (APECS) 

In clinical research, the randomized controlled trial is a gold-standard study design, considered to be the highest-quality evidence that informs how doctors care for patients.

Over the past five years, we enrolled 178 older adults with moderate-to-severe eosinophilic COPD in our study. We randomly supplied study participants with either two real air purifiers or two sham purifiers (that otherwise look and sound like real purifiers) to be used continuously in their homes for a full year. This random assignment enables us to identify differences in health outcomes between the two groups that are caused by use of real air purifiers. We tracked symptoms and lung function, and collected blood and samples from the nose to measure inflammation. We collected air samples from their homes five times to measure exposure to harmful particles. Today, about 50 people remain in this study and are scheduled to complete a final clinical visit later this year. 

These participants are older adults with severe lung disease who have committed countless hours to this study. They provided blood and nasal tissue. They accommodated air samplers and HEPA filter machines in their homes. They knew that their participation may not provide any direct benefit to them. They agreed to participate because of an understanding that this research, upon completion, would yield important conclusions that could help people with COPD. 

Study interrupted: What the cancellation of APECS means for people 

Now, because of the funding cancellation, those conclusions may never come. If cut short, we risk collecting too little data to reach any clear findings about the effectiveness of air purifiers in managing eosinophilic COPD. Biological samples that were already collected may go unanalyzed. All the time and effort of the participants with COPD – and all the taxpayer dollars that funded this research – will be wasted. 

The greatest impact will be felt by the millions of Americans with eosinophilic COPD. Without clear data from this trial, it remains unknown if air purification is a clinically effective treatment that warrants long-term use. Repeating a trial of this scale would take years. 

The bigger picture 

The early termination of the APECS trial is more than just a pause in a research project – it’s a setback for science, medicine, and the many people living with chronic lung disease today and in the future. Abruptly terminating any federally funded research is a wasteful disservice to public health and society at large.   

All perspectives expressed in the Harvard Climate Blog are those of the authors and not of Harvard University or the Salata Institute for Climate and Sustainability. Any errors are the authors’ own. The Harvard Climate Blog is edited by an interdisciplinary team of Harvard faculty.