Bronchial thermoplasty; its long-term efficacy in severe asthma
P. Wijsman*a (Ms), A. Goorsenberga (Dr), J. D'Hooghea (Dr), N. Ten Hackenb (Dr), E. Weersinka (Dr), E. Bela (Prof), P. Shahc (Prof), J. Annemaa (Prof), P. Bontaa (Dr)
a Amsterdam UMC location University of Amsterdam, Amsterdam, NETHERLANDS ; b University Medical Center Groningen, University of Groningen, Groningen, NETHERLANDS ; c Royal Brompton Hospital, Department of Pulmonology, London, UNITED KINGDOM
* p.c.wijsman@amsterdamumc.nl
Background Bronchial thermoplasty (BT) is a bronchoscopic treatment for uncontrolled severe asthma patients who remain uncontrolled despite optimal medical therapy. Previously we published the data of the TASMA RCT (Goorsenberg AWM et al. AJRCCM 2021; 203:175-184), which showed clinical benefit 6 months after BT. The aim of this study is to analyse the long-term clinical outcomes of BT.
Methods 22 severe asthma patients of the TASMA trial in the Netherlands were followed for 2,5 years after BT. Main outcome parameters were the Asthma Quality of Life Questionnaire (AQLQ), the Asthma Control Questionnaire (ACQ) and annualized exacerbation rate. Statistical analysis was done by ANOVA for repeated measures and Bonferroni post-test.
Results A repeated measures ANOVA showed that mean AQLQ (p<0,001), ACQ (p<0.001), and exacerbation rate (p=0,004) all differ significantly between time points. Post hoc tests using the Bonferroni correction revealed that after 2,5 years AQLQ improves by an average of 1,1 (p=0,003), ACQ improves by an average of 0.9 (p=0,02) and exacerbation rate reduced with an average of 2,8 (p=0,09).
Conclusion BT results in persistent improvement in quality of life and asthma control and reduction in exacerbation rate. Data of this trial mirror the results on AQLQ, ACQ and exacerbation rate of previous RCTs and large registries. BT should be considered as a valuable treatment for severe asthma with favourable long term outcomes.
Disclosure of funding source(s):
This study was supported by the Netherlands Lung Foundation (Grant number: 5.2.13.064JO), Stichting Astma Bestrijding (SAB): grant nr. 1018/041 and The Netherlands Organization for Health Research and Development (ZonMw grant number: 90713477) and Boston Scientific Corporation.