NDLI: Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wechsler, Michael E. Laviolette, Michel Rubin, Adalberto S. Fiterman, Jussara Lapa E. Silva, Jose R. Shah, Pallav L. Fiss, Elie Olivenstein, Ronald Thomson, Neil C. Niven, Robert M. Pavord, Ian D. Simoff, Michael Hales, Jeff B. McEvoy, Charlene Slebos, Dirk-Jan Holmes, Mark Phillips, Martin J. Erzurum, Serpil C. Hanania, Nicola A. Sumino, Kaharu Kraft, Monica Cox, Gerard Sterman, Daniel H. Hogarth, Kyle Kline, Joel N. Mansur, Adel H. Louie, Brian E. Leeds, William M. Barbers, Richard G. Austin, John H. M. Shargill, Narinder S. Quiring, John Armstrong, Brian Castro, Mario
Description	Author Affiliation: Wechsler ME ( Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colo. Electronic address: mikewechsler@gmail.com.)
Abstract	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 ß2-agonists.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
DOI	10.1016/j.jaci.2013.08.009
Journal	Journal of Allergy and Clinical Immunology
Issue Number	6
Volume Number	132
Language	English
Publisher	Elsevier
Publisher Date	2013-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Asthma Therapy Electric Stimulation Therapy Adrenal Cortex Hormones Therapeutic Use Adrenergic Beta-agonists Epidemiology Disease Progression Drug Resistance Emergency Medical Services Statistics & Numerical Data Hospitalization Recurrence Time Factors Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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