Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma.
BACKGROUND: Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma. OBJECTIVE: We sought to assess the effectiveness and safety of BT in asthmatic patients 5 years after therapy. METHODS: BT-treated subjects from the A...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2013
|
| _version_ | 1826260778423943168 |
|---|---|
| author | Wechsler, M Laviolette, M Rubin, A Fiterman, J Silva, L Shah, P Fiss, E Olivenstein, R Thomson, N Niven, R Pavord, I Simoff, M Hales, J McEvoy, C Slebos, D Holmes, M Phillips, M Erzurum, S Hanania, N Sumino, K Kraft, M Cox, G Sterman, D Hogarth, K Kline, J |
| author_facet | Wechsler, M Laviolette, M Rubin, A Fiterman, J Silva, L Shah, P Fiss, E Olivenstein, R Thomson, N Niven, R Pavord, I Simoff, M Hales, J McEvoy, C Slebos, D Holmes, M Phillips, M Erzurum, S Hanania, N Sumino, K Kraft, M Cox, G Sterman, D Hogarth, K Kline, J |
| author_sort | Wechsler, M |
| collection | OXFORD |
| description | BACKGROUND: Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma. OBJECTIVE: We sought to assess the effectiveness and safety of BT in asthmatic patients 5 years after therapy. METHODS: BT-treated subjects from the Asthma Intervention Research 2 trial (ClinicalTrials.govNCT01350414) were evaluated annually for 5 years to assess the long-term safety of BT and the durability of its treatment effect. Outcomes assessed after BT included severe exacerbations, adverse events, health care use, spirometric data, and high-resolution computed tomographic scans. RESULTS: One hundred sixty-two (85.3%) of 190 BT-treated subjects from the Asthma Intervention Research 2 trial completed 5 years of follow-up. The proportion of subjects experiencing severe exacerbations and emergency department (ED) visits and the rates of events in each of years 1 to 5 remained low and were less than those observed in the 12 months before BT treatment (average 5-year reduction in proportions: 44% for exacerbations and 78% for ED visits). Respiratory adverse events and respiratory-related hospitalizations remained unchanged in years 2 through 5 compared with the first year after BT. Prebronchodilator FEV₁ values remained stable between years 1 and 5 after BT, despite a 18% reduction in average daily inhaled corticosteroid dose. High-resolution computed tomographic scans from baseline to 5 years after BT showed no structural abnormalities that could be attributed to BT. CONCLUSIONS: These data demonstrate the 5-year durability of the benefits of BT with regard to both asthma control (based on maintained reduction in severe exacerbations and ED visits for respiratory symptoms) and safety. BT has become an important addition to our treatment armamentarium and should be considered for patients with severe persistent asthma who remain symptomatic despite taking inhaled corticosteroids and long-acting β₂-agonists. |
| first_indexed | 2024-03-06T19:11:07Z |
| format | Journal article |
| id | oxford-uuid:16ccc1d9-bf59-4924-b13f-2f30f7c31771 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:11:07Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:16ccc1d9-bf59-4924-b13f-2f30f7c317712022-03-26T10:33:30ZBronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:16ccc1d9-bf59-4924-b13f-2f30f7c31771EnglishSymplectic Elements at Oxford2013Wechsler, MLaviolette, MRubin, AFiterman, JSilva, LShah, PFiss, EOlivenstein, RThomson, NNiven, RPavord, ISimoff, MHales, JMcEvoy, CSlebos, DHolmes, MPhillips, MErzurum, SHanania, NSumino, KKraft, MCox, GSterman, DHogarth, KKline, JBACKGROUND: Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma. OBJECTIVE: We sought to assess the effectiveness and safety of BT in asthmatic patients 5 years after therapy. METHODS: BT-treated subjects from the Asthma Intervention Research 2 trial (ClinicalTrials.govNCT01350414) were evaluated annually for 5 years to assess the long-term safety of BT and the durability of its treatment effect. Outcomes assessed after BT included severe exacerbations, adverse events, health care use, spirometric data, and high-resolution computed tomographic scans. RESULTS: One hundred sixty-two (85.3%) of 190 BT-treated subjects from the Asthma Intervention Research 2 trial completed 5 years of follow-up. The proportion of subjects experiencing severe exacerbations and emergency department (ED) visits and the rates of events in each of years 1 to 5 remained low and were less than those observed in the 12 months before BT treatment (average 5-year reduction in proportions: 44% for exacerbations and 78% for ED visits). Respiratory adverse events and respiratory-related hospitalizations remained unchanged in years 2 through 5 compared with the first year after BT. Prebronchodilator FEV₁ values remained stable between years 1 and 5 after BT, despite a 18% reduction in average daily inhaled corticosteroid dose. High-resolution computed tomographic scans from baseline to 5 years after BT showed no structural abnormalities that could be attributed to BT. CONCLUSIONS: These data demonstrate the 5-year durability of the benefits of BT with regard to both asthma control (based on maintained reduction in severe exacerbations and ED visits for respiratory symptoms) and safety. BT has become an important addition to our treatment armamentarium and should be considered for patients with severe persistent asthma who remain symptomatic despite taking inhaled corticosteroids and long-acting β₂-agonists. |
| spellingShingle | Wechsler, M Laviolette, M Rubin, A Fiterman, J Silva, L Shah, P Fiss, E Olivenstein, R Thomson, N Niven, R Pavord, I Simoff, M Hales, J McEvoy, C Slebos, D Holmes, M Phillips, M Erzurum, S Hanania, N Sumino, K Kraft, M Cox, G Sterman, D Hogarth, K Kline, J Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title | Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title_full | Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title_fullStr | Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title_full_unstemmed | Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title_short | Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. |
| title_sort | bronchial thermoplasty long term safety and effectiveness in patients with severe persistent asthma |
| work_keys_str_mv | AT wechslerm bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT laviolettem bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT rubina bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT fitermanj bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT silval bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT shahp bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT fisse bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT olivensteinr bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT thomsonn bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT nivenr bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT pavordi bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT simoffm bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT halesj bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT mcevoyc bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT slebosd bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT holmesm bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT phillipsm bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT erzurums bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT hananian bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT suminok bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT kraftm bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT coxg bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT stermand bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT hogarthk bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma AT klinej bronchialthermoplastylongtermsafetyandeffectivenessinpatientswithseverepersistentasthma |