Safety of bronchial thermoplasty in patients with severe refractory asthma

Pavord, I.D., Thomson, N.C., Niven, R.M., Corris, P.A., Chung, K.F., Cox, G., Armstrong, B., Shargill, N.S. and Laviolette, M. (2013) Safety of bronchial thermoplasty in patients with severe refractory asthma. Annals of Allergy, Asthma and Immunology, 111(5), pp. 402-407. (doi: 10.1016/j.anai.2013.05.002)

Abstract

Background: Patients with severe refractory asthma treated with bronchial thermoplasty (BT), a bronchoscopic procedure that improves asthma control by reducing excess airway smooth muscle, were followed up for 5 years to evaluate long-term safety of this procedure.<p></p> Objectives: To assess long-term safety of BT for 5 years.<p></p> Methods: Patients with asthma aged 18 to 65 years requiring high-dose inhaled corticosteroids (ICSs) (>750 μg/d of fluticasone propionate or equivalent) and long-acting β2-agonists (LABAs) (at least 100 μg/d of salmeterol or equivalent), with or without oral prednisone (≤30 mg/d), leukotriene modifiers, theophylline, or other asthma controller medications were enrolled in the Research in Severe Asthma (RISA) Trial. Patients had a prebronchodilator forced expiratory volume in 1 second of 50% or more of predicted, demonstrated methacholine airway hyperresponsiveness, had uncontrolled symptoms despite taking maintenance medication, abstained from smoking for 1 year or greater, and had a smoking history of less than 10 pack-years.<p></p> Results: Fourteen patients (of the 15 who received active treatment in the RISA Trial) participated in the long-term follow-up study for 5 years. The rate of respiratory adverse events (AEs per patient per year) was 1.4, 2.4, 1.7, and 2.4, respectively, in years 2 to 5 after BT. There was a decrease in hospitalizations and emergency department visits for respiratory symptoms in each of years 1, 2, 3, 4, and 5 compared with the year before BT treatment. Measures of lung function showed no deterioration for 5 years.<p></p> Conclusion: Our findings suggest that BT is safe for 5 years after BT in patients with severe refractory asthma.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Thomson, Professor Neil
• Authors: Pavord, I.D., Thomson, N.C., Niven, R.M., Corris, P.A., Chung, K.F., Cox, G., Armstrong, B., Shargill, N.S., and Laviolette, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: Annals of Allergy, Asthma and Immunology
• Publisher: Elsevier
• ISSN: 1081-1206
• ISSN (Online): 1534-4436