Bronchial thermoplasty in patients with very severe asthma: Safety and clinical outcomes

Abstract

Background: Studies are needed to better understand bronchial thermoplasty (BT) effects in patients with severe obstructive asthma (low FEV1) or in whom systemic corticosteroids are used, and its long-term benefits and safety. BT validation studies have usually excluded this more severe patients Objective: To assess effectiveness and safety of BT in very severe asthma patients. Methods: Review of 22 BT patients. 14 Patients with FEV1 10 mg per day, were considered more severe. Results: 62 BT procedures with 20 adverse events mild to moderate and 8 severe (severe exacerbations or lobar complete atelectasis). 68% had no adverse events, 32% had mild or moderate and 13% severe. There were no differences in mild-moderate complications in both groups. One patient in each group discontinued treatment after a severe exacerbation, after the first procedure. Although no statistical difference was obtained, an incidence of severe complications of 17% in the most severe group was observed, with a 4.3% in the less severe one (p=0.243) Conclusions: BT reduced emergency department visits and provided improvement in quality of life. BT is a safe procedure. No statistically significant differences were detected, although there may be a trend to increased risk of severe exacerbations in the more severe group.