Bronchial Thermoplasty - Severe Asthma Treatment
Posted by kevvyg on Monday, March 10, 2014
Anatomy of an Asthma AttackFor those dealing with asthma, the standard treatment is generally a combination of corticosteroids (anti-inflammatories), leukotriene modifiers (reduce leukotrienes, preventative), and beta agonists (open airways long & short term). There are other drugs and combined drugs, but these three types typically cover most patients. Beyond managing asthma better with medication, exercising and avoiding known triggers, there are few options when it comes to asthma. In 2010, the FDA approved the Alair Bronchial Thermoplasty system, an approach to treating asthma that does not involve medication. After a few years of use, this treatment is showing decent results for those with the most severe asthma, but what does this treatment entail and how does it work?

Simply put, bronchial thermoplasty (BT) is the process of inserting a catheter into the airways and heat to reduce the mass of the smooth muscle tissue that surround the airways. What the doctor is typically doing during this outpatient procedure is administering moderate sedation while inserting the tube/catheter. Each treatment lasts about an hour, with the entire treatment taking three sessions with three weeks in between each session.

Clinical trials and subsequent use of the technique have shown that for people with severe persistent asthma, for whom drug treatments are not effective, BT might be an alternative. In short term, two year, and five year trials, patients saw significant and sustained reductions in the number of emergency room and unscheduled doctors visits, and this trend has continued with usage of the treatment amongst the greater population of severe asthma sufferers. Another, but lesser benefit, has been that some people have been able to slightly reduce the medication they take to manage their asthma.

As with any medical procedure, there are some risks involved, and this type of treatment is not recommended but for about 5-10% of the asthmatic population (the segment with the most severe and most resistant to drug treatments). The process itself can be uncomfortable as most people will experience wheezing or coughing shortly after treatment, due to the irritation of the airways by the BT procedure.

It is important to note a few other things with BT. First, it is not a cure. There is no known cure for asthma. Second, this treatment if only available for people with severe asthma, for whom standard medications do not work well. Third, though this type of treatment may help, it is not going to take the place of medication. In many ways, it seems to help medication be more effective in people, for whom previously it did not work. This type of treatment is not near as universally available as prescription asthma medications, so for many, it simply may not be available.

To read the abstract of the 5-year trial, one of the earliest clinical trials, or for more information on the FDA approved device itself.

Author: Kevin Gilmore

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