Analysis of the clinical efficacy and safety of bronchial thermoplasty in the treatment of patients with severe asthma and asthma-chronic obstructive pulmonary disease overlap
S. Hua (Ms), F. Long*a (Prof), P. Fua (Mr)
a University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, CHINA
Objective To explore whether bronchial thermoplasty (BT) is safe and effective in treating severe asthma and asthma-chronic obstructive pulmonary disease (COPD) overlap. Methods We retrospectively enrolled 49 ACO cases receiving BT and 50 severe asthma cases undergoing BT at University of Chinese Academy of Sciences Shenzhen Hospital from January 2016 to December 2018. Cases were divided into overlapping and Asthma groups. Their baseline data were recorded. Lung function, hormone consumption, Asthma Control Test ACT, Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Questionnaire (ACQ), and chronic obstructive pulmonary disease assessment test (CAT) and Modified British Medical Research Council (mMRC) scores, and adverse reactions 3-week post-treatment were comparatively analyzed. Results Overlapping group had an older age, longer smoking history and disease course, higher pre-treatment lung function indexes FVC, FEV1, and FEV1% pred, but lower inhaled hormone dosage than asthma group (Ps<0.05). No differences were in pre-treatment ACT, ACQ, and AQLQ scores (Ps>0.05). At 3-month post-treatment, FEV1% pred and inhaled hormone dosage in overlapping group were not improved (Ps>0.05), while others were better than pre-treatment (Ps<0.05). At 1-year post-treatment, all indicators significantly improved than pre-treatment, with asthma group having better effects (Ps<0.05). Overlapping group had higher cough and blood sputum rates within 3-week post-treatment than asthma group, whereas excessive sputum and short-term wheezing rates decreased (Ps<0.05). Differences in chest tightness, chest pain, segmental atelectasis and pneumonia were significant (Ps>0.05), and postoperative adverse reactions were effectively controlled shortly. Conclusion BT improves lung function and life quality in asthma patients and those with COPD, with higher effects on asthma patients and no serious adverse events.
Disclosure of funding source(s): none