Bronchial Thermoplasty: Activations Predict Response

Overview

Journal Respir Res

Specialty Pulmonary Medicine

Date 2017 Jul 6

PMID 28676053

Citations 23

Authors

David Langton

Joy Sha

Alvin Ing

David Fielding

Francis Thien

Virginia Plummer

Affiliations

Soon will be listed here.

Abstract

Background: Bronchial thermoplasty (BT) is an emerging bronchoscopic intervention for the treatment of severe asthma. The predictive factors for clinical response to BT are unknown. We examined the relationship between the number of radiofrequency activations applied and the treatment response observed.

Methods: Data were collected from 24 consecutive cases treated at three Australian centres from June 2014 to March 2016. The baseline characteristics were collated along with the activations delivered. The primary response measure was change in the Asthma Control Questionnaire-5 (ACQ-5) score measured at 6 months post BT. The relationship between change in outcome parameters and the number of activations delivered was explored.

Results: All patients met the ERS/ATS definition for severe asthma. At 6 months post treatment, mean ACQ-5 improved from 3.3 ± 1.1 to 1.5 ± 1.1, p < 0.001. The minimal clinically significant improvement in ACQ-5 of ≥0.5 was observed in 21 out of 24 patients. The only significant variable that differed between the 21 responders and the three non-responders was the number of activations delivered, with 139 ± 11 activations in the non-responders, compared to 221 ± 45 activations in the responders (p < 0.01). A significant inverse correlation was found between change in ACQ-5 score and the number of activations, r = -0.43 (p < 0.05).

Conclusions: The number of activations delivered during BT has a role in determining clinical response to treatment.

Citing Articles

A Case Series of Patients Undergoing Bronchial Thermoplasty a Second Time for Severe Asthma.

Foo C, Langton D, Thien F J Asthma Allergy. 2024; 17:1239-1245.

PMID: 39634379 PMC: 11616413. DOI: 10.2147/JAA.S492730.

Use of Quantitative CT Imaging to Identify Bronchial Thermoplasty Responders.

Samant M, Krings J, Lew D, Goss C, Koch T, McGregor M Chest. 2023; 165(4):775-784.

PMID: 38123124 PMC: 11026166. DOI: 10.1016/j.chest.2023.12.015.

Endobronchial Ultrasound is Useful in the Assessment of Bronchial Wall Changes Related to Bronchial Thermoplasty.

Soja J, Gorka K, Gross-Sondej I, Jakiela B, Mikrut S, Okon K J Asthma Allergy. 2023; 16:585-595.

PMID: 37284335 PMC: 10241211. DOI: 10.2147/JAA.S404254.

Bronchial thermoplasty in severe asthma: a real-world study on efficacy and gene profiling.

Facciolongo N, Bonacini M, Galeone C, Ruggiero P, Menzella F, Ghidoni G Allergy Asthma Clin Immunol. 2022; 18(1):39.

PMID: 35534846 PMC: 9087992. DOI: 10.1186/s13223-022-00680-4.

Recent advances in bronchial thermoplasty for severe asthma: a narrative review.

Wu S, Li S, Zhang P, Fang N, Qiu C Ann Transl Med. 2022; 10(6):370.

PMID: 35434008 PMC: 9011210. DOI: 10.21037/atm-22-580.

References

Castro M, Rubin A, Laviolette M, Fiterman J, De Andrade Lima M, Shah P . Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial. Am J Respir Crit Care Med. 2009; 181(2):116-24. PMC: 3269231. DOI: 10.1164/rccm.200903-0354OC. View

Chung K, Wenzel S, Brozek J, Bush A, Castro M, Sterk P . International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2013; 43(2):343-73. DOI: 10.1183/09031936.00202013. View

Bousquet J, Mantzouranis E, Cruz A, Ait-Khaled N, Baena-Cagnani C, Bleecker E . Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010; 126(5):926-38. DOI: 10.1016/j.jaci.2010.07.019. View

Pretolani M, Dombret M, Thabut G, Knap D, Hamidi F, Debray M . Reduction of airway smooth muscle mass by bronchial thermoplasty in patients with severe asthma. Am J Respir Crit Care Med. 2014; 190(12):1452-4. DOI: 10.1164/rccm.201407-1374LE. View

Chakir J, Haj-Salem I, Gras D, Joubert P, Beaudoin E, Biardel S . Effects of Bronchial Thermoplasty on Airway Smooth Muscle and Collagen Deposition in Asthma. Ann Am Thorac Soc. 2015; 12(11):1612-8. DOI: 10.1513/AnnalsATS.201504-208OC. View

Miller J, Cox G, Vincic L, Lombard C, Loomas B, Danek C . A prospective feasibility study of bronchial thermoplasty in the human airway. Chest. 2005; 127(6):1999-2006. DOI: 10.1378/chest.127.6.1999. View

Dombret M, Alagha K, Boulet L, Brillet P, Joos G, Laviolette M . Bronchial thermoplasty: a new therapeutic option for the treatment of severe, uncontrolled asthma in adults. Eur Respir Rev. 2014; 23(134):510-8. PMC: 9487396. DOI: 10.1183/09059180.00005114. View

Quanjer P, Tammeling G, Cotes J, Pedersen O, Peslin R, Yernault J . Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993; 16:5-40. View

Juniper E, Svensson K, Mork A, Stahl E . Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respir Med. 2005; 99(5):553-8. DOI: 10.1016/j.rmed.2004.10.008. View

10.

Pavord I, Cox G, Thomson N, Rubin A, Corris P, Niven R . Safety and efficacy of bronchial thermoplasty in symptomatic, severe asthma. Am J Respir Crit Care Med. 2007; 176(12):1185-91. DOI: 10.1164/rccm.200704-571OC. View

11.

Wahidi M, Kraft M . Bronchial thermoplasty for severe asthma. Am J Respir Crit Care Med. 2011; 185(7):709-14. DOI: 10.1164/rccm.201105-0883CI. View

12.

Miller M, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R . General considerations for lung function testing. Eur Respir J. 2005; 26(1):153-61. DOI: 10.1183/09031936.05.00034505. View

13.

Keglowich L, Borger P . The Three A's in Asthma - Airway Smooth Muscle, Airway Remodeling & Angiogenesis. Open Respir Med J. 2015; 9:70-80. PMC: 4475688. DOI: 10.2174/1874306401509010070. View

14.

Cox G, Thomson N, Rubin A, Niven R, Corris P, Siersted H . Asthma control during the year after bronchial thermoplasty. N Engl J Med. 2007; 356(13):1327-37. DOI: 10.1056/NEJMoa064707. View