Bronchial thermoplasty for moderate or severe persistent asthma in adults

Summary

A Cochrane review «Bronchial thermoplasty for moderate or severe persistent asthma in adults»1 «Torrego A, Solà I, Munoz AM et al. Bronchial thermoplasty for moderate or severe persistent asthma in adults. Cochrane Database Syst Rev 2014;(3):CD009910. »1 included 3 studies with a total of 429 subjects. In bronchial thermoplasty controlled radiofrequency-generated heat is delivered via a catheter inserted into the bronchial tree of the lungs through a flexible bronchoscope and thus reducing airway smooth muscle. Two studies compared bronchial thermoplasty vs medical management and one compared bronchial thermoplasty vs a sham intervention. There was no difference in symptom control or pulmonary function parameters but proportion of participants visiting the emergency department for respiratory symptoms were reduced (table «Bronchial thermoplasty compared with medical management or sham intervention for persistent asthma in adults»1). Quality of life was improved with bronchial thermoplasty, although that was not clinically significant. Two trials reported on exacerbations: One showed no significant differences in number of severe exacerbations per week. Another study showed a lower rate of severe exacerbations per participant per year in thermoplasty group compared with controls (0.48 ± 0.067 vs 0.70 ± 0.122 exacerbations per patient-year, respectively) and a significantly lower proportion of participants experiencing severe exacerbations (26% vs 40% of participants). Risk of respiratory adverse events (mostly mild or moderate) and hospitalisation for respiratory adverse events during the treatment period of thermoplasty were higher (table «Bronchial thermoplasty compared with medical management or sham intervention for persistent asthma in adults»1).