Bronchial thermoplasty for asthma

被引:205
作者
Cox, G
Miller, JD
McWilliams, A
FitzGerald, JM
Lam, S
机构
[1] McMaster Univ, Firestone Inst Resp Hlth, St Josephs Healthcare, Hamilton, ON L8N 4A6, Canada
[2] Univ British Columbia, Vancouver Gen Hosp, Vancouver, BC V5Z 1M9, Canada
关键词
airway smooth muscle; asthma; bronchoscopy; radiofrequency energy;
D O I
10.1164/rccm.200507-1162OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: Bronchial thermoplasty (BT) reduces the potential for smooth muscle-mediated bronchoconstriction by reducing the mass of smooth muscle in the walls of conducting airways. Objectives: This study was conducted to examine the safety and impact on lung function and airway responsiveness of BT over 2 yr. Methods: The safety of BT was studied in 16 subjects with mild to moderate asthma. Baseline and 12-wk post-treatment measurements included spirometry, methacholine challenge, daily diary recordings of peak flow, symptoms, and medication usage. Subjects completed follow-up evaluations at 12 wk, 1 yr, and 2 yr. Measurements and Main Results: The procedure was well tolerated; side effects were transient and typical of what is commonly observed after bronchoscopy. All subjects demonstrated improvement in airway responsiveness. The mean PC20 increased by 2.37 +/- 1.72 (p < 0.001), 2.77 +/- 1.53 (p = 0.007), and 2.64 +/- 1.52 doublings (p < 0.001), at 12 wk, 1 yr, and 2 yr post-procedure, respectively. Data from daily diaries collected for 12 wk indicated significant improvements over baseline in symptom-free days (p = 0.015), morning peak flow (p = 0.01), and evening peak flow (p = 0.007). Spirometry measurements remained stable throughout the study period. Conclusions: BT is well tolerated in patients with asthma and results in decreased airway hyperresponsiveness that persists for at least 2 yr.
引用
收藏
页码:965 / 969
页数:5
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