Which short-term results and long-term outcomes are associated with bronchial thermoplasty in the treatment of asthma?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A group of patients (AIR2 Trial Study Group) with severe asthma who remained symptomatic despite treatment with high-dose inhaled corticosteroids and long-acting beta2 agonists underwent BT and showed superior improvement from baseline in their score on the Asthma Quality of Life Questionnaire (AQLQ) (BT, 1.35±1.10; sham, 1.16±1.23). Changes in AQLQ of 0.5 or greater were seen in 79% of BT and in 64% of sham subjects. Although the hospitalization rate was 6% higher among BT subjects 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. [93]

Further results from the AIR2 study showed lasting efficacy at 5 years, as well as a reduction in maintenance treatment and healthcare utilization. The study also highlights the possibility that more patients may benefit from this treatment. [94]

Wechsler and colleagues examined the long-term safety and effectiveness of bronchial thermoplasty in 162 patients with severe persistent asthma from the Asthma Intervention Research 2 (AIR2) trial, which showed a 32% reduction in severe asthma exacerbations, an 84% reduction in respiratory symptom-related emergency department visits, a 73% reduction in hospitalizations for respiratory symptoms, and a 66% reduction in time lost from work/school/other daily activities because of asthma symptoms. [95, 96]


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