Clinical predictor for prognosis of bronchial thermoplasty in treating severe asthma

S. Zhuquan*^a (Dr), L. Shiyue^a (Prof)

^a The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, CHINA

* py1011xiaoquan@163.com

Objective: To explore the clinical indicators for predicting the curative effect of bronchial thermoplasty (BT) in the treatment of severe asthma.

Methods: Patients diagnosed with severe asthma and treated with BT were enrolled in this study. The demographic characteristics, ACQ score, peripheral blood eosinophil, FeNO, induced sputum, lung function test, as well as endotracheal optical coherence tomography (EB-OCT) and BT activation number were collected and analyzed. All the recruited subjects received 2 years follow-up visit after BT treatment and divided into the “effective group” and “ineffective group”.

Results: A total of 30 patients with severe asthma were enrolled, 22 patients in the effective group and 8 cases in ineffective group. Triglycerides (1.15±0.34mmol/L v.s. 1.73±0.81 mmol/L), body weight (60.8kg v.s. 72.6kg), BMI (23.6±2.9 v.s. 26.1±2.9), FeNO (24.5±15.6 v.s. 48.6±30.4), lung function parameters (Fres: 17.16±5.42 v.s. 11.78±3.99, X5: -0.17±0.07 v.s. -0.08±0.04, AX: 0.97±0.89 v.s. 0.31±0.25, RV: v.s. 1.84±0.50, RV/TLC: 45.08±9.26 v.s. 35.18±9.12), as well as EB-OCT parameters (medium-sized airway wall area percentage, Aw%3-6) were significantly different between effective and ineffective group. Whereas, there was no notable difference in gender, age, onset age, sinusitis, eosinophil count, spirometry (FEV1, FVC) and BT activation number between the two groups. ROC analysis was conducted to predict the BT efficacy: Aw%3-6 (AUC=0.744), FeNO (AUC=0.700), X5 (AUC 0.861), RV/TLC (AUC 0.762) and BMI (AUC=0.756).

Conclusion: IOS, FeNO and EB-OCT, but not BT activation number, could be conducive to predict the efficacy of BT treatment and screen suitable asthmatic cases. Patients with overweight and/or hyperlipidemia might serve as risk factors affecting the efficacy of BT.

Disclosure of funding source(s): none