Effectiveness and Safety of Bronchial Thermoplasty in the Treatment of Severe Asthma with Smoking History: A Single-Center Experience
- 19 May 2020
- journal article
- research article
- Published by S. Karger AG in International Archives of Allergy and Immunology
- Vol. 181 (7), 522-528
- https://doi.org/10.1159/000507446
Abstract
Introduction: Bronchial thermoplasty (BT) improves asthma-related quality of life and decreases the number of asthma exacerbations. However, the effectiveness of BT in the treatment of severe asthma with smoking history is unclear because previous studies have excluded patients with smoking history of more than 10 pack-years. Objective: The aim of the study was to clarify the effectiveness and safety of BT for severe asthma with smoking history. Methods: We retrospectively reviewed patients who received BT and compared its effectiveness and safety with and without smoking history. Results: Seven patients were assigned to the smoking group and 9 to the nonsmoking group. Before BT, despite Global Initiative for Asthma step 4 or 5 treatment including oral corticosteroids (OCS) or monoclonal antibody drugs, most patients in both groups had asthma-related symptoms every day (85.7 vs. 77.8%; p = 0.475) and frequent asthma exacerbations. After BT, in the smoking group, 3 patients could discontinue or reduce OCS and all 3 patients treated with monoclonal antibody drugs could discontinue them. In the smoking group, 6 patients (85.7%) experienced a reduction in the rate of symptoms, of which 3 patients (42.9%) had a disappearance of symptoms, similar to the nonsmoking group. BT was effective in 5 patients (83.3%) in the smoking group and 6 patients (75.0%) in the nonsmoking group. There were no severe complications. Conclusions: BT was found to be effective and safe for treatment of severe asthma with smoking history. Our results suggest that BT may be a therapeutic option for asthma-chronic obstructive pulmonary disease overlap.Keywords
This publication has 17 references indexed in Scilit:
- Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlationsJournal of Allergy and Clinical Immunology, 2016
- Understanding asthma-chronic obstructive pulmonary disease overlap syndromeRespiratory Medicine, 2015
- Effects of Bronchial Thermoplasty on Airway Smooth Muscle and Collagen Deposition in AsthmaAnnals of the American Thoracic Society, 2015
- Asthma-COPD overlap 2015: now we are sixThorax, 2015
- The eXpeRience registry: The ‘real-world’ effectiveness of omalizumab in allergic asthmaRespiratory Medicine, 2013
- Investigation of the freely available easy-to-use software ‘EZR’ for medical statisticsBone Marrow Transplantation, 2012
- Effectiveness and Safety of Bronchial Thermoplasty in the Treatment of Severe AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2010
- The overlap syndrome of asthma and COPD: what are its features and how important is it?Thorax, 2009
- Bronchial hyperresponsiveness and the development of asthma and COPD in asymptomatic individuals: SAPALDIA Cohort StudyThorax, 2006
- Differences in Airway Inflammation in Patients with Fixed Airflow Obstruction Due to Asthma or Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2003