Safety and effectiveness of bronchial thermoplasty after 10 years in patients with persistent asthma (BT10+): a follow-up of three randomised controlled trials

Chaudhuri, Rekha; Rubin, Adalberto Sperb; Sumino, Kaharu; Silva, José Roberto Lapa e; Niven, Robert; Siddiqui, Salman; Klooster, Karin; McEvoy, Charlene; Shah, Pallav L.; Simoff, Michael; Khatri, Sumita; Barbers, Richard G.; Grubb, G. Mark; McMullen, Edmund; Olson, Jennifer L.; Laviolette, Michel

doi:10.1016/s2213-2600(20)30408-2

Cited by 70 publications

(54 citation statements)

References 22 publications

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“…The benefits appear to be sustained over 10 years following the procedure. 137 This treatment is not approved for children.…”

Section: Other Precision Treatments For Severe Asthmamentioning

confidence: 99%

Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction

Ramphul¹,

Lo²,

Gaillard³

2021

JAA

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Asthma is a heterogeneous disease, characterised by different phenotypes and endotypes. Precision medicine in asthma refers to the implementation of a targeted therapy for each individual child, based on the identification of treatable traits, including environmental, immunological and genetic factors. Severe asthma in children is associated with increased hospitalisation rates, a lower quality of life, increased healthcare costs and an increased mortality. In the era of new molecular biologics treatments, it is essential to improve deep phenotyping of children with severe asthma in order to deliver the most effective treatment to each individual child. In this review, we discuss the personalised approach to the assessment and management of severe asthma. We explore the indications and use of the currently licensed biologics, as well as the potential of other emerging treatments.

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“…The benefits appear to be sustained over 10 years following the procedure. 137 This treatment is not approved for children.…”

Section: Other Precision Treatments For Severe Asthmamentioning

confidence: 99%

Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction

Ramphul¹,

Lo²,

Gaillard³

2021

JAA

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“…For the subgroup analyses, subgroups analysed were those based on gender, age (<40 and ≥40 years), baseline body mass index (BMI) (≤30 and >30 kg/m 2 ) and smoking history as well as baseline AQLQ (≤4.0 and >4.0), baseline oral corticosteroid use, baseline postbronchodilator FEV 1 % predicted (≤70% and>70%) and number of complete catheter activations (≤140 and >140). 25 A generalised linear mixed model with binomial error distribution was fit with factors of the subgroup, time and interaction of subgroup and time with subject as a random effect; if the interaction had a p value <0.10, contrasts of time within subgroup and subgroup within time were performed to explore differences. SAS V.9.4 (SAS Institute) was used for all analyses.…”

Section: Methodsmentioning

confidence: 99%

Bronchial Thermoplasty Global Registry (BTGR): 2-year results

et al. 2021

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ObjectivesBronchial thermoplasty (BT) is a device-based treatment for subjects ≥18 years with severe asthma not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Bronchial Thermoplasty Global Registry (BTGR) collected real-world data on subjects undergoing this procedure.DesignThe BTGR is an all-comer, prospective, open-label, multicentre study enrolling adult subjects indicated for and treated with BT.SettingEighteen centres in Spain, Italy, Germany, the UK, the Netherlands, the Czech Republic, South Africa and AustraliaParticipantsOne hundred fifty-seven subjects aged 18 years and older who were scheduled to undergo BT treatment for asthma. Subjects diagnosed with other medical conditions which, in the investigator’s opinion, made them inappropriate for BT treatment were excluded.Primary and secondary outcome measuresBaseline characteristics collected included demographics, Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Test (ACT), medication usage, forced expiratory volume in one second and forced vital capacity, medical history, comorbidities and 12-month baseline recall data (severe exacerbations (SE) and healthcare utilisation). SE incidence and healthcare utilisation were summarised at 1 and 2 years post-BT.ResultsSubjects’ baseline characteristics were representative of persons with severe asthma. A comparison of the proportion of subjects experiencing events during the 12 months prior to BT to the 2-year follow-up showed a reduction in SE (90.3% vs 56.1%, p<0.0001), emergency room visits (53.8% vs 25.5%, p<0.0001) and hospitalisations (42.9% vs 23.5 %, p=0.0019). Reductions in asthma maintenance medication dosage were also observed. AQLQ and ACT scores improved from 3.26 and 11.18 at baseline to 4.39 and 15.54 at 2 years, respectively (p<0.0001 for both AQLQ and ACT).ConclusionsThe BTGR demonstrates sustained improvement in clinical outcomes and reduction in asthma medication usage 2 years after BT in a real-world population. This is consistent with results from other BT randomised controlled trials and registries and further supports improvement in asthma control after BT.Trial registration numberNCT02104856.

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“…Thirteen subjects out of 97 had bronchiectasis out of which 6 developed bronchiectasis after being treated with BT. Overall, this study shows that the benefits of BT are persistent for 10+ years [ 14 ].…”

Section: Safety and Efficacy Of Btmentioning

confidence: 96%

Bronchial Thermoplasty in Patients with Severe Persistent Asthma: A Literature Review

Aftab

Rehman

Ahmad

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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The literature review aimed to see the safety and efficacy of bronchial thermoplasty in patients with severe asthma. We searched the online database, PUBMED, using bronchial thermoplasty and asthma as the key words and including trials from 2007 to 2021. Our review found that bronchial thermoplasty reduces asthma-related hospitalizations, emergency room visits and asthma exacerbations with sustained benefits for 5-10 years. This came at the expense of increased asthma-related adverse events, most commonly during the 7 days immediately after the procedure. Adverse events from 6 weeks after procedure to up to 5 years were similar between the bronchial thermoplasty group and the medication-only group. Bronchial thermoplasty is a safe and efficacious treatment modality for patients with severe asthma.

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Safety and effectiveness of bronchial thermoplasty after 10 years in patients with persistent asthma (BT10+): a follow-up of three randomised controlled trials

Cited by 70 publications

References 22 publications

Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction

Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction

Bronchial Thermoplasty Global Registry (BTGR): 2-year results

Bronchial Thermoplasty in Patients with Severe Persistent Asthma: A Literature Review

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