Bronchial Thermosplaty and severe asthma with frequent severe exacerbations : a controlled study

Abstract

<b>Background:</b> Bronchial thermoplasty (BT) is a bronchoscopic procedure for patients with severe uncontrolled asthma. However, there is no data on BT effectiveness in severe asthmatic patients with frequent severe exacerbations. Aim to assess the effectiveness of BT in severe asthma patients with frequent exacerbations in a controlled study on a 12 months period. <b>Methods:</b> 30 patients, GINA 5 asthma, who had at least four exacerbations over the previous year, were randomized to BT or control groups (C). Primary outcome was to compare the number of exacerbations on a 12 months period after BT. <b>Results:</b> All patients except 3 had a previous non efficient biotherapy. In the previous year, BT and C group&nbsp;had 5 and 6 severe exacerbations, respectively. At inclusion, the BT and C group, oral steroids intake was 9.3 and 11.0mg/day, respectively. Primary outcome was met since BT group had 1.58 less severe exacerbations as compared to C (p=0.047). Severe exacerbations were 6.09 in BT group and 9.62 in C. Oral steroids intake on the whole study was significantly lower in BT group, ratio of 0.61 (p=0.0002). Evolution of AQLQ and ACQ-7 between inclusion and last visit were significantly improved in the BT group. Only few mild to moderate adverse events were reported and were controlled within days. <b>Conclusion:</b> We have demonstrated in a controlled study with severe asthmatic patients with frequent severe exacerbations that BT decreased significantly the rate of severe exacerbations, oral steroids intake, AQLQ and ACQ-7, on a twelve months period. BT appears to be an interesting alternativ to biotherapy in severe asthmatic.