they touch the airway walls. Then heat is used to shrink the smooth muscle layer beneath so it can’t tighten up and cause an asthma attack.
“What we have is a remodeling of the patient’s airway. That reduces the severity of their disease,” Chupp says.
The findings were published in the March issue of the journal CHEST.
Asthma is an inflammation of the airways. Many components of that inflammation can make it difficult to control, says Dr. Albert Rizzo, chief medical officer for the American Lung Association.
Typically, doctors treat it with anti-inflammatory medications and drugs that dilate the airways, Rizzo, who was not involved with the research adds.
“Why some patients don’t respond to those is still a mystery that we have,” Rizzo says. “And it may be a result of different parts of the inflammatory pathway not being as well-controlled in certain patients. And again, this goes to the immune system and the genetics of the immune system, which a lot of unraveling has to still be done.”
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Rizzo said it’s important to have treatment solutions, because severe asthma affects a patient’s quality of life and is sometimes fatal.
The study adds to evidence that this surgery is an alternative for those people who don’t respond well to other treatments.
“It’s still a matter of picking the right person: Who can have this done and benefit from it,” he says. “And it is a procedure, like many other procedures, that should be done by individuals who have been doing it for a period of time. Not every pulmonary specialist should be doing this. It’s something that more proficiency comes out of repeatedly doing it.”
Chupp says researchers haven’t found any long-term adverse events through the five-year data. There are, however, some short-term risks.
The procedure is completed in three phases, each about a month a part and each treating a different part of the lungs. There is some risk that a patient could have a severe asthma attack, bleeding and require respirator support, according to the study. That risk became progressively lower over the years of follow-up, it found.
Chupp hopes further studies will refine the treatment and better pinpoint which patients are ideal candidates for surgery.
One barrier to treatment: Insurance companies may not cover the procedure because they consider it experimental.
“I think that bronchial thermoplasty should continue to be part of treatment algorithms for patients with severe asthma,” Chupp adds. “And I think we should consider doing studies where it’s used in conjunction with biologics potentially to increase the disease-modifying effect so that we can improve outcomes even more in patients and potentially get them into clinical remission.”
If you are having a hard time managing your asthma and/or your medication is not working, contact your doctor to discuss what can be done to provide you relief.