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Published ahead of print on February 2, 2006, doi:10.1164/rccm.200507-1162OC

Am. J. Respir. Crit. Care Med., Volume 173, Number 9, May 2006, 965-969

A more recent version of this article appeared on May 1, 2006
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Submitted on July 27, 2005
Accepted on January 31, 2006

Bronchial ThermoplastyTM For Asthma

Gerard Cox1*, John D Miller1, Annette McWilliams2, J. Mark FitzGerald2, and Stephen Lam2

1 Firestone Institute for Respiratory Health, McMaster University, St. Joseph's Healthcare, Hamilton, ON, Canada, 2 Vancouver Coastal Research Institute, University of Bristish Columbia, Vancouver General Hospital, Vancouver, BC, Canada

* To whom correspondence should be addressed. E-mail: coxp{at}mcmaster.ca.

Rationale: Bronchial Thermoplasty reduces the potential for smooth muscle-mediated bronchoconstriction by reducing the mass of smooth muscle in the walls of conducting airways. Objectives: This study was conducted to examine the safety, impact on lung function and airway responsiveness of Bronchial Thermoplasty over 2 years. Methods: The safety of Bronchial Thermoplasty was studied in 16 subjects with mild to moderate asthma. Baseline and 12-week post-treatment measurements included spirometry, methacholine challenge, daily diary recordings of peak flow, symptoms and medication usage. Subjects completed follow-up evaluations at 12 weeks, one and two years. Measurements and Main Results: The procedure was well-tolerated; side effects were transient and typical of what is commonly observed after bronchoscopy. All subjects demonstrated improvement in airway responsiveness. The mean PC20 increased by 2.37 ±1.72 (P < 0.001), 2.77 ±1.53 (P = 0.007), and 2.64 ±1.52 doublings (P < 0.001), at 12 weeks, 1 and 2 years post-procedure respectively. Data from daily diaries collected for 12 weeks indicated significant improvements over baseline in symptom-free days (P=0.015), morning peak flow (P=0.01), and evening peak flow measurements (P≤0.007). Spirometry measurements remained stable throughout the study period. Conclusions: Bronchial Thermoplasty is well-tolerated in patients with asthma, and results in decreased airway hyperresponsiveness that persists for at least 2 years.
Key words: asthma, bronchoscopy, airway smooth muscle, radiofrequency energy




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