Bronchial thermoplasty effective in long term

Researchers have shown that the asthma-control benefits of bronchial thermoplasty remain for as long as 5 years following treatment.

Follow-up results from 162 patients with severe asthma in the Asthma Intervention Research 2 Trial show that the proportion experiencing severe exacerbations was significantly reduced in the year following treatment and remained low during the subsequent 4 years.

This led to an average 44% decrease over the entire 5-year follow-up period in the 51.6% of subjects who experienced exacerbations in the year prior to the procedure.

Similarly, the initial reduction in the proportion of patients visiting the emergency department was sustained throughout, resulting in an average 78% reduction compared with the 12 months before the procedure.

The authors, led by Michael Wechsler (National Jewish Health, Denver, Colorado), also report that pre-bronchodilator forced expiratory volume in 1 second values remained unchanged during the 5-year follow-up. And, compared with baseline when all subjects were prescribed two or more maintenance asthma medications, 28% reduced their inhaled corticosteroid use by 50% or more.

Additionally, the team notes that there was a sustained reduction in respiratory adverse events during the follow-up period, and no incidence of pneumothorax, intubation or mechanical ventilation, cardiac arrhythmias, or death. And, there were no significant structural changes in the airways seen under high-resolution computed tomography, which the authors describe as “reassuring.”

“These data confirm the previously established safety profile,” the team comments in the Journal ofAllergy & Clinical Immunology.

They say that the findings may help physicians to balance the short-term risks of bronchial thermoplasty, which can lead to a transient increase in adverse events, against the long-term benefits.

“A single [bronchial thermoplasty] treatment comprising 3 procedures provides long-term benefit to at least 5 years,” they write.

“Whether [bronchial thermoplasty] is a disease-modifying therapy will depend on the results of future appropriately designed clinical studies,” they conclude.

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