Research Profile: Adnan Majid, MD

Adnan Majid, MD

Associate Professor of Medicine, Harvard Medical School

 

Chief of Interventional Pulmonology, BIDMC

Research Group

Daniel Alape, MD
Alex Chee, MD
Andres de Lima, MD
Sebastian Fernandez- Bussy, MD
Erik Folch, MD, MSc
Christian Ghattas, MD
Van Holden, MD
Fayez Kheir, MD
Timothy LeClair, MD
Mathieu Marcoux, MD
Mihir Parikh, MD
Estefania Rivera, MD
Melibea Sierra, MD
Rani Singh, PhD

Research Focus

Our research is clinical in nature and aims at improving care for patients with a variety of lung, airway, and pleural disorders. Our research areas include:

Emphysema

Prospective, Randomized, Controlled Multicenter Clinical Study to Evaluate the Safety and Effectiveness of the IBV® Valve System for the Single Lobe Treatment of Severe Emphysema (EMPROVE). We are evaluating the improvement of lung function after treatment with the IBV® Valve System compared to medical management. Benefits of the IBV to patients may include:

  • Reduction in lung volume
  • Improvement in pulmonary function and quality of life

Lung Function Improvement after Bronchoscopic Lung Volume Reduction with Pulmonx Endobronchial Valves (EBV) Used in Treatment of Emphysema (LIBERATE). This is a phase 3, multi-center, prospective, randomized, controlled study with EBV treatment. Benefits to patients may include:

  • Improvement in lung function
  • Increased exercise tolerance
Prolonged air leaks

Safety and Effectiveness of the Spiration Valve System in Air Leaks, Valves against Standard Therapy (VAST). We are evaluating the treatment with the Spiration Valve System (SVS) as compared to standard chest tube drainage management and other standard-of-care interventions in this multicenter, prospective, randomized, controlled study. Benefits to the patients may include:

Reduction in air leak resolution time and overall hospital stay

Lung cancer diagnostics

Evaluation of the ArchimedesTM System for Transparenchymal Nodules Access 2 (EAST 2). The purpose of this study is to continue evaluating the safety and performance of an updated version of the LungPoint System (called the ArchimedesTM System) for aiding the physician in guiding endoscopic tools to pulmonary nodule(s) located more distally in parenchymal tissue.  Benefits of this system may include:

  • Higher yield rate than existing bronchoscopic biopsy modalities
  • Patient access to a minimally invasive bronchoscopic approach to the diagnosis of lung cancer

A Multi-Center Trial of the ProLung TestTM (Transthoracic Bioconductance Measurement) as an Adjunct to CT Chest Scans for the Risk Stratification of Patients with Pulmonary Lesions Suspicious for Lung Cancer. This study aims to demonstrate the safety and efficacy of the ProLung Test in the risk stratification of patients with pulmonary lesions identified by CT that are suspicious for lung cancer.

Tracheobronchomalacia

Our division maintains the largest tracheobronchomalacia (TBM) registry in the United States, which has enabled us to develop current guidelines for medical, endoscopic, and surgical therapy.

Airway Stents for Excessive Dynamic Airway Collapse: A Randomized Trial. This study is a prospective, randomized clinical trial to determine the role of airway stenting and to identify patients with excessive dynamic airway collapse (EDAC) who may benefit from surgical correction or repair.

Malignant pleural effusions

A Pivotal Multi-Center, Randomized, Controlled, Single Blinded Study Comparing the Silver Nitrate-Coated Indwelling Pleural Catheter (SNCIPC) to the Uncoated PleurX® Pleural Catheter for the Management of Symptomatic, Recurrent, Malignant Pleural Effusions (SWIFT). The purpose for the protocol is to perform a prospective, multicenter, randomized, controlled clinical trial to examine the clinical utility and efficacy of indwelling pleural catheter material on pleurodesis in the treatment of symptomatic, recurrent malignant pleural effusions, comparing silver-nitrate coated vs uncoated (standard-of-care device) pleural catheters.

Accomplishments 2016-2017

Dr. Fayez Kheir was recently awarded the 2016-2017 American Association of Bronchology and Interventional Pulmonology (AABIP) Research Award. I am one of the mentors on this project, entitled “Fibrinolytic Therapy versus Medical Thoracoscopy for Treatment of Pleural Infection.” This trial is a prospective, randomized clinical trial to compare two currently accepted standard-of-care treatment strategies for the management of pleural infections in adults. This proposal was selected as the best among several high-quality submissions sent to the AABIP Award Committee.

While participating in the EMPROVE and LIBERATE Trials, we identified a subgroup of patients for which endobronchial lung volume reduction by way of intrabronchial valves (IBVs) was not an option due to incomplete interlobar fissures. In 2016-2017, in collaboration with Dr. Sidhu Gangadharan and Spiration, Inc., we successfully showed complete targeted lobar collapse through a minimally invasive surgical stapling technique to complete interlobar fissures followed by IBV placement in both ex-vivo and live animal models. In 2018, we plan to transition this research to a pivotal human clinical trial in hopes of helping patients who would otherwise not be candidates for such treatment.

Invited Presentations
  • Management of Hemoptysis Workshop; American Thoracic Society: Post Graduate Course, Washington, DC, 2017
  • Role of Bronchoscopy in Asthma Diagnosis; Clinica Alemana, Universidad del Desarrollo, Santiago, Chile, 2017
  • Bronchial Thermoplasty: Choosing the Right Patient; Clinica Alemana, Universidad del Desarrollo, Santiago, Chile, 2017
  • EBUS-TBNA: Indications, diagnostic yield, complications; Peruvian Association of Bronchology and Interventional Pulmonology, Lima, Peru, 2017
  • EBUS: Other Applications; Peruvian Association for Bronchology and Interventional Pulmonology, Lima, Peru, 2017
  • Live EBUS Case at Maison de Sante; Peruvian Association for Bronchology and Interventional Pulmonology, Lima, Peru, 2017
  • New Diagnostic Techniques in Lung Cancer; V Bienal de Neumologia, Seville, Spain, 2017

Teaching, Training, and Education

The Interventional Pulmonary (IP) Fellowship Program at BIDMC started in 2000 and merged with the Massachusetts General Hospital (MGH) IP fellowship in 2012 to create the Combined BIDMC-MGH IP Fellowship Program, of which I am the director. Our fellowship is one of the largest in the nation. Each year we accept three physicians into the competitive one-year program. Over the last 17 years, 31 fellows have graduated from the program and moved on to develop successful programs around the United States.

We also offer a variety of educational activities for trainees and faculty at BIDMC and around the world, including our annual “Introduction to Interventional Pulmonology” course.

Abstracts, Posters, and Exhibits

Alape D, Kheir F, Gangadharan S, Parikh M, Wilson J, Chee A, Majid A. Stent trial for expiratory central airway collapse: Does the type of stent really matter? CHEST Conference, Toronto, ON, 2017

Sierra M, Ferandez-Bussy S, Mehta H, Kheir F, Barry M, Jantz M, Chee A, Parikh M, Majid A. Bronchial thermoplasty in severe uncontrolled asthma with different phenotypes. CHEST Conference, Toronto, ON, 2017

De Lima A, Kheir F, Fernandez-Bussy S, Parikh M, Chee A, Majid A. Tunneled pleural catheters for the treatment of patients with pleural infection and a non-expandable lung: A single-center case series. CHEST Conference, Toronto, ON, 2017

Ghattas C, Kheir F,Gesthalter Y, Parikh M, Chee A, Sierra M,  Majid A. Sonographic features of lymph nodes during endobronchial ultrasound guided transbronchial needle aspiration in comparison with mediastinoscopy. CHEST Conference, Toronto, ON, 2017

Rivera E, Kheir F, Chee A, Parikh M, Fernandez-Bussy S, Majid A. Volumetric analysis of pleural effusions: a quantitative comparison between Chest CT and thoracentesis drainage. CHEST Conference, Toronto, ON, 2017

Selected Publications

Kheir F, Rivera E, Majid A. An adolescent with dyspnea and cough: A case of congenital tracheal stenosis. Am J Respir Crit Care Med 2017;196(7):e30-e31.

Majid A, Kheir F, Chung J, Alape D, Husta B, Oh S, Folch E. Covered balloon-expanding stents in airway stenosis. J Bronchology Interv Pulmonol 2017;24(2):174-177.

Fernandez-Bussy S, Labarca G, Majid A. In reply: Biodegradable stent for vanishing bronchus syndrome after lung transplantation. J Heart Lung Transplant 2017;36(5):592.

Buitrago DH, Wilson JL, Parikh M, Majid A, Gangadharan SP. Current concepts in severe adult tracheobronchomalacia: Evaluation and treatment. J Thorac Dis 2017;9(1):E57-E66.

Majid A, Ochoa S, Chatterji S, Fernandez-Bussy S, Kheir F, Rivera E, Cheng G, Folch E. Safety and efficacy of tissue plasminogen activator and DNase for complicated pleural effusions secondary to abdominal pathology. Ann Am Thorac Soc 2017;14(3):342-346.