Non-Pneumatic Active Compression Device vs. Advanced Pneumatic Compression Device for Treating Lower Extremity Lymphedema: Impact on the Medicare-Eligible Population

Objective: Chronic edema, whether systemic or localized, is often underrecognized by providers due to limited awareness of its prevalence and debilitating impact. As result, patients suffering from this condition live with suboptimal management, diminished quality of life, and increased healthcare costs. Non-pneumatic compression devices (NPCDs) have been shown to be safe and more clinically effective in treating lymphedema (LED) than advanced pneumatic compression devices (APCD) in multiple published studies. In the latest study, the TEAYS trial, NPCDs showed superior clinical utility, better outcomes, and higher patient adherence than APCDs for managing lower extremity swelling. This sub-analysis of the TEAYS study focuses on outcomes for patients aged 65 and above diagnosed with lymphedema in the lower extremity. Methods: This trial was a randomized, crossover, head-to-head study across nine sites in the US in 2023. Patients were subjected to an initial 4-week washout period and then randomized to either the NPCD or a commercially available APCD. Patients used the randomly assigned initial device for 90 days followed by a second washout period before a 90-day use of the second device. Results: Analysis included a total of 71 patients with lower extremity lymphedema, 27 of whom were aged 65 or above, and this subset comprises the study cohort for the current study. These patients achieved statistically greater mean limb volume reduction (353.9 ± 99.17 mL) while on NPCD vs. APCD (−10.7 ± 125.59 mL). NPCD also showed significantly better improvement in overall quality of life (1.43 ± 0.45) vs. APCD (−0.10 ± 0.34). Statistically significant improvement in adherence was also observed while on NPCD (77%) vs. APCD (23%). No device-related adverse events were reported. Conclusions: For adults aged 65 and older with lower extremity lymphedema, non-pneumatic compression devices (NPCDs) demonstrated superior clinical outcomes—including greater limb volume reduction, improved mobility, higher adherence, and patient satisfaction—compared to advanced pneumatic compression devices (APCDs), supporting NPCDs as an effective, patient-preferred solution.