Bronchial thermoplasty in uncontrolled severe persistent asthma. Preliminary results

Abstract

INTRODUCTION: Bronchial Thermoplasty (BT) is a novel bronchoscopic procedure for patients with severe asthma who remain symptomatic despite maximal medical therapy. OBJETIVE: To describe effectiveness and safety of BT according to preliminary results at our Hospital. METHODS: We performed BT in 7 patients with uncontrolled severe persistent asthma with frequent exacerbations.Data were available on each subject at 6 months following BT.We described the number of activations, duration of procedure,quality of life,exacerbations,adverse respiratory events and lung function. RESULTS: The mean (±SEM) pre-bronchodilator forced expiratory volume in one second (FEV1) prior to BT was 54.5 ± 12% of predicted, the mean age was 57± 13 years, number of hospitalizations and exacerbations for asthma in the year prior to BT was 0.14 ± 0.3 and 3.86 ± 3.7 respectively, medium dose inhaled corticosteroids 2257 ± 921 mcg/day and 2 patients were on systemic corticosteroids. In the first session there were 55 activations and 9 activation failures. There was a tendency to increase the number of activations and failures in the third session (72 and 11 respectively). At 6 months we evaluated 5 patients; FEV 1 (%pred) improved 9 points (p=0.299),the ACT 4(p=0.750),the AQLQ-General in Sydney 2.1(p=0.160) and exacerbations of 2.1(p=0.076).Wilcoxon test was used for quantitative variables.p ≤0.05. CONCLUSIONS: The BT is a safe technique,with a tendency to improvement in quality of life,FEV 1 (%pred)and number of exacerbations. This is a small size sample and doesn´t allow definitive conclusions in our population.