Efficacy of bronchial thermoplasty in a patient panel with uncontrolled severe persistent asthma.

Autor:	Zikos A; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, USA., Balaan M; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, USA., Hobart E; Care Analytics Department, Highmark Health, Pittsburgh, PA, USA., Bansal S; Department of Internal Medicine, The Lung Center, Penn Highlands Healthcare, Dubois, PA, USA., Saeed R; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, USA., Cheema T; Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, USA., Gentile D; Department of Health Science, Saint Francis University, Loretto, PA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of asthma : official journal of the Association for the Care of Asthma [J Asthma] 2024 Aug; Vol. 61 (8), pp. 867-875. Date of Electronic Publication: 2024 Feb 04.
DOI:	10.1080/02770903.2024.2309532
Abstrakt:	Background: Bronchial thermoplasty (BT) is an approved procedure to manage uncontrolled severe persistent asthma. Many insurance providers are reluctant to pay for BT without proven benefit among their specific patient panel. Objective: Determine if BT is effective in a panel patient panel with uncontrolled severe persistent asthma. Study Design and Methods: This was an unblinded prospective study of adult subjects with uncontrolled severe persistent asthma who underwent BT. Outcomes were assessed at baseline and then 3-, 6-, 12-, 18- and 24-months post-BT. The primary metric was an improved Asthma Quality of Life Questionnaire (AQLQ) score. Other metrics included improved Asthma Control Test (ACT), peak expiratory flow rates (PEFR), spirometry, fractional excretion of nitric oxide (FeNO), number of unscheduled medical visits, and lost days of work/activity. Respiratory adverse events were assessed during the BT treatment period and at each post-BT visit. Results: Twenty-nine subjects completed the study; the median interquartile range (IQR) age was 47 (42-61), and the majority were female (69%), white (93%), and non-Hispanic (90%). After BT, mean (±std) AQLQ scores improved by 1.6(±1.1) at 3 months ( p  < 0.0001), 1.6(±1.2) at 6 months ( p  < 0.0001), 1.4(±1.0) at 12 months ( p  < 0.0001), 1.8(±1.1) at 18 months ( p  < 0.0001), and 1.6 (±1.5) at 24 months ( p  < 0.0001). There were significant improvements in ACT, PEFR, unscheduled medical visits and lost days of work and activity. Spirometry and FeNO metrics were unchanged. The average cost for subjects completing all 3 BT procedures was approximately $15,000. Conclusion: BT is an effective adjunctive therapeutic modality in subjects with uncontrolled severe persistent asthma.
Databáze:	MEDLINE
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