Bronchial thermoplasty reduces asthma exacerbation and improves quality of life in asthma with type 2 inflammation

Background: Bronchial thermoplasty (BT) is suggested for asthma patients with type 2 inflammation who are not eligible for or unresponsive to biologic drugs. In this study, we aimed to study the effectiveness of BT in asthma patients with type 2 inflammation. Methods: This is a retrospective observational analytic study that enrolled moderately-severe asthma patients with type 2 inflammation; who did not respond to medium-dosed inhaled corticosteroids, longacting beta2-agonists, and at least one other controller; to receive BT. All patients did not respond to or could not afford biologics. We collected the Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Test (ACT), pulmonary function test, number of emergency department visits, and hospitalizations at baseline, 3-, 6-, and 12-month post-treatment. Adverse events were also recorded. Results: Seventeen patients completed the 12-month follow-up after BT. There were significant improvements from baseline in total AQLQ scores from 3.57 [interquartile range (IQR): 2] to 4.88 [IQR: 2.3] (P=0.004). All AQLQ domains were significantly improved. The ACT score also significantly improved from 13 [IQR: 5] to 20 [IQR: 7] (P=0.004). There were significant decreases in emergency department visits from 4 [IQR: 11] to 2 [IQR: 5] (P=0.01), hospitalizations from 1 [IQR: 2] to 0 [IQR: 1] (P=0.03), systemic steroid dose used from 5 [IQR: 5] to 1.25 [IQR: 5] mg per day (P=0.03), and days of reliever used in 2 weeks from 14 [IQR: 6] to 0 [IQR: 3] (P=0.001). All Omalizumab was discontinued within 12 months after BT. Common adverse events were wheezing and dyspnea and no serious complications were found. Conclusions: BT is an alternative and effective treatment for asthma with type 2 inflammation without serious complications.