Bronchial Thermoplasty Benefits Are Sustained for 5 Years

Bronchial thermoplasty is a bronchoscopic therapy for asthma in which controlled thermal energy is delivered to the airway wall during a series of three procedures. The result is a prolonged reduction in airway smooth muscle mass. In a 2010 study, 288 adults with severe asthma were randomized to bronchial thermoplasty or sham procedures and were followed for 1 year. A statistically significant improvement in asthma-related quality-of-life scores was not clinically significant because of greater-than-expected improvement in the sham group. Hospitalizations during the initial 6-week treatment period were 6% in the thermoplasty group; during weeks 6 to 52, severe exacerbations (defined by new or higher-dose oral corticosteroids or doubling of inhaled corticosteroids) were 33% less likely in the thermoplasty group. However, most outcomes were similar in the two groups (Am J Respir Crit Care Med 2010; 181:116).

Most of the thermoplasty patients were followed for an additional 4 years. Rates of respiratory-related adverse events and hospitalizations remained unchanged in years 2 to 5 compared with year 1. Exacerbations were 44% less likely to occur, and emergency department visits were 78% less likely to occur in years 2 to 5 than in the year preceding thermoplasty. Inhaled corticosteroid use was 18% lower than in the year before thermoplasty.