Bronchial Thermoplasty does it provide long-term asthma control

Bronchial Thermoplasty (BT) has been shown to result in significant improvements in a number of asthma control measures in three randomized clinical trials in patients with moderate-to-severe, persistent asthma. The Asthma Intervention Research 2 (AIR2) Trial, a double-blind, sham-controlled, randomized clinical trial of BT in patients with severe asthma, showed a 32% reduction in severe exacerbations, an 84% reduction in emergency room visits due to respiratory symptoms, and a 66% reduction in time lost from work due to asthma symptoms compared to a sham-treated group in the first year following the BT treatment period.

Wechsler at el describe their findings on the long-term safety and durability of BT out to 5 years post-treatment in BT-treated patients from the AIR2 Trial. They found that the reduction in the percentage of BT-treated patients experiencing severe exacerbations (compared to sham-treated patients) seen at 1 year was maintained out to 5 years with a 48% average decrease over 5 years in severe exacerbation event rates in BT-treated patients compared with the 12 months prior to BT treatment. There was a substantial reduction in the use of systemic corticosteroids associated with those exacerbations. Similarly, the reduction in the percentage of BT-treated patients having emergency room visits for respiratory symptoms (compared to sham -treated patients) seen at 1 year was maintained out to 5 years. There was no increase over 5 years in hospitalizations, respiratory adverse events, or asthma symptoms. In addition, one in 4 BT-treated patients (28%) saw a 50% or greater reduction from baseline average ICS dose at 5 years, with an average reduction of 18% from baseline for BT-treated patients at 5 year. The authors demonstrated long term safety based on the absence of clinically meaningful changes in lung function (FEV1) and no structural changes in the airways at 5 years.

This supports BT as an important option for patients with severe asthma who remain symptomatic despite taking current standard of care medications.

Author

Saraleen Benouni, MD Dr. Benouni specializes in the treatment of asthma, allergies, atopic dermatitis, and immune disorders for both adults and children. She has presented and published research at national allergy meetings and has authored papers on drug allergies and skin conditions. She is a member of the American College and American Academy of Allergy, Asthma, and Immunology, and the Los Angeles Society of Allergy, Asthma, and Clinical Immunology.