The Impact of Bronchial Thermoplasty on Asthma-Related Quality of Life and Controller Medication Use

Respiration. 2019;98(2):165-170. doi: 10.1159/000499404. Epub 2019 May 2.

Abstract

Background: Despite an improved understanding of the pathophysiology of asthma, severe asthma sufferers continue to experience a poor quality of life (QOL). Bronchial thermoplasty (BT) utilizes thermal energy to reduce airway smooth muscle. In industry-sponsored trials, BT improves QOL and reduces severe exacerbations; however, the impact of BT on asthma-related QOL and medication use in non-industry-sponsored trials is less clear.

Objective: The aim of this study was to determine the impact of BT on asthma QOL measures (mini-AQLQ) and asthma controller medication use during the year following treatment with BT.

Methods: We performed a prospective study of the impact of BT in 25 patients with severe persistent asthma. Our primary outcome was change in asthma-related QOL score (mini-AQLQ) 1 year after BT treatment. Our secondary outcome was change in asthma medication use 1 year after BT.

Results: BT led to an improvement in mini-AQLQ score from a baseline of 3.6 ± 0.3 before therapy to 5.6 ± 0.3 1 year after the final BT procedure. Overall, 88% percent of patients showed a clinically significant improvement in mini-AQLQ at 1 year. Patients treated with BT showed a reduction in the use of montelukast and omalizumab 1 year after BT.

Conclusion: In patients with severe persistent asthma and low asthma-related QOL scores, BT leads to an improvement in asthma-related QOL and a decrease in asthma medication use when measured 1 year after the final BT treatment.

Keywords: Asthma; Asthma-related quality of life; Bronchial thermoplasty.

MeSH terms

  • Acetates / therapeutic use
  • Administration, Inhalation
  • Administration, Oral
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-Agonists / therapeutic use
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Asthma / psychology
  • Asthma / surgery*
  • Bronchial Thermoplasty*
  • Cholinergic Antagonists / therapeutic use
  • Cyclopropanes
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Omalizumab / therapeutic use
  • Prospective Studies
  • Quality of Life*
  • Quinolines / therapeutic use
  • Severity of Illness Index
  • Sulfides
  • Treatment Outcome
  • Vital Capacity

Substances

  • Acetates
  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Anti-Asthmatic Agents
  • Cholinergic Antagonists
  • Cyclopropanes
  • Quinolines
  • Sulfides
  • Omalizumab
  • montelukast