Bronchial thermoplasty

Asthma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Asthma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies Pulmonary Function Test Bronchial Challenge Test Exhaled nitric oxide
Treatment
Emergency Management
Medical Therapy
Alternative and Complementary Medicine
Bronchial Thermoplasty
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Bronchial thermoplasty On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Bronchial thermoplasty All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Bronchial thermoplasty
CDC on Bronchial thermoplasty
Bronchial thermoplasty in the news
Blogs on Bronchial thermoplasty
Directions to Hospitals Treating Asthma
Risk calculators and risk factors for Bronchial thermoplasty

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Bronchial thermoplasty is a new investigational outpatient procedure that is performed in the hospital bronchoscopy suite and is currently performed only in conjunction with the AIR2 Trial. The procedure uses controlled thermal energy to reduce the surface area of the smooth muscle in the bronchiole; thereby, helps to prevent future asthma attacks.

Bronchial Thermoplasty

Mechanisms of Benefit

• The objective of the procedure is to reduce the airway smooth muscle in all airways reachable by the bronchoscope in hopes of reducing the airways ability to constrict.
• A bronchial thermoplasty treatment session is expected to take less than an hour to complete; it is expected that three treatment sessions will be required to treat the entire lung system.
• Bronchial thermoplasty is an outpatient procedure. No general anesthesia is used, no incision is necessary, and there is no need to stay overnight. However, the patient will need to continue on their current asthma medications for the duration of the study.

Supportive Trial Data

The AIR2 trial, involved 288 patients with severe asthma who remained symptomatic despite treatment with high-dose inhaled corticosteroids and long-acting β2-agonists, who underwent bronchial thermoplasty (BT) to evaluate the effectiveness and safety of BT. The study demonstrated significant improvement from the baseline based on the Asthma Quality of Life Questionnaire (AQLQ) in the BT group (BT, 1.35 +/- 1.10; sham, 1.16 +/- 1.23). Changes in the AQLQ score of 0.5 or greater was observed in 79% of BT group and 64% of sham group. Although the hospitalization rate was 6% higher among BT group during the treatment period (up to 6 wk after BT), in the posttreatment period (6-52 wk after BT), the BT group experienced fewer severe exacerbations, emergency department visits, and days missed from work/school compared with the sham group (PPS, 95.5, 99.9, and 99.3%, respectively). Thus, the study concluded that in patients with severe asthma, bronchial thermoplasty significantly improved asthma-specific quality of life with a reduction in severe exacerbations and healthcare use noted in the posttreatment period.