Bronchial thermoplasty

Revision as of 13:09, 29 March 2013 by Kalsang Dolma (talk | contribs)
Jump to navigation Jump to search

Asthma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Asthma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Pulmonary Function Test
Bronchial Challenge Test
Exhaled nitric oxide

Treatment

Emergency Management

Medical Therapy

Alternative and Complementary Medicine

Bronchial Thermoplasty

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Bronchial thermoplasty On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Bronchial thermoplasty

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Bronchial thermoplasty

CDC on Bronchial thermoplasty

Bronchial thermoplasty in the news

Blogs on Bronchial thermoplasty

Directions to Hospitals Treating Asthma

Risk calculators and risk factors for Bronchial thermoplasty

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Bronchial thermoplasty is a new investigational outpatient procedure that is performed in the hospital bronchoscopy suite and is currently performed only in conjunction with the AIR2 Trial.[1] The procedure uses controlled thermal energy to reduce the surface area of the smooth muscle in the bronchiole; thereby, helps to prevent future asthma attacks.

Bronchial Thermoplasty

Mechanisms of Benefit

  • The objective of the procedure is to reduce the airway smooth muscle in all airways reachable by the bronchoscope in hopes of reducing the airways ability to constrict.
  • A bronchial thermoplasty treatment session is expected to take less than an hour to complete; it is expected that three treatment sessions will be required to treat the entire lung system.
  • Bronchial thermoplasty is an outpatient procedure. No general anesthesia is used, no incision is necessary, and there is no need to stay overnight. However, the patient will need to continue on their current asthma medications for the duration of the study.

Supportive Trial Data

The AIR2 trial, involved 288 patients with severe asthma who remained symptomatic despite treatment with high-dose inhaled corticosteroids and long-acting β2-agonists, who underwent bronchial thermoplasty (BT) to evaluate the effectiveness and safety of BT. The study demonstrated significant improvement from the baseline based on the Asthma Quality of Life Questionnaire (AQLQ) in the BT group (BT, 1.35 +/- 1.10; sham, 1.16 +/- 1.23). Changes in the AQLQ score of 0.5 or greater was observed in 79% of BT group and 64% of sham group. Although the hospitalization rate was 6% higher among BT group 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 (PPS, 95.5, 99.9, and 99.3%, respectively). Thus, the study concluded that in patients with severe asthma, bronchial thermoplasty significantly improved asthma-specific quality of life with a reduction in severe exacerbations and healthcare use noted in the posttreatment period.[1]

References

  1. 1.0 1.1 Castro M, Rubin AS, Laviolette M, Fiterman J, De Andrade Lima M, Shah PL et al. (2010) Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial. Am J Respir Crit Care Med 181 (2):116-24. DOI:10.1164/rccm.200903-0354OC PMID: 19815809

Template:WS