Bronchial Thermoplasty: Is It Beneficial for Severe Asthma?

Bronchial thermoplasty (BT) is associated with benefits among patients with severe, uncontrolled asthma that persist at 5 years, according to a study presented at CHEST 2020.

The researchers conducted a prospective, open-label, observational, multi-center trial involving 284 patient, aged 18 to 65 years, who were taking 1000μg/day or more of inhaled corticosteroids (ICS) and ≥80μg/day or more of long-acting beta-agonists. Included participants were non-smokers for at least 1 years, had 2 or more days of asthma symptoms in the past 4 weeks, had been hospitalized 2 or fewer times prior to BT, and had 3 or fewer severe exacerbations in the year before BT.

Overall, the percentage of individuals who experience severe exacerbations following BT decreased over 5 years (78%, 50%, 47%, 47%, 44%, and 43% at 12 months prior to BT and 1, 2, 3, 4, and 5 years after BT, respectively). Similarly, percentages of hospitalizations and ER visits also decreased over the 5 years following BT.

Further, the percentage of patients using maintenance oral corticosteroids decreased from 19.4% at baseline to 8.1%-10.7% during years 1 through 5, although use of mepolizumab and benralizumab increased during the study period.

“The Post-FDA Approval Clinical Trial Evaluating BT in Severe Persistent Asthma study data indicates that improvements in asthma control with respect to severe exacerbations, hospitalizations and ER visits after BT are durable out to 5 years, and reductions in ICS and maintenance OCS usage are maintained,” they concluded.

—Michael Potts

Reference:

Chupp G, Kline J, Khatri S, et al. Long-term efficacy and safety of bronchial thermoplasty: 5-year follow-up results from a large-scale prospective study. Presented at CHEST 2020. Allergy and Airway. 2020;158(4):Supp A12-A16. Doi : https://doi.org/10.1016/j.chest.2020.08.059