Using heat to treat asthma

An outpatient procedure that uses mild heat on the inside of a person’s airway is proving effective in reducing asthma attacks and emergency room visits for adults with severe asthma.

A bronchial thermoplasty cuts emergency room visits for respiratory-related symptoms by as much as 84 percent in the first year following the procedure and reduces severe asthma attacks by nearly a third, which decreases health care costs. Results of one clinical study found almost 80 percent of patients treated with the procedure have significant improvement in their overall quality of life.

“This treatment is truly a revolutionary approach to the care of the adult asthma patient,” says Dr. Tabassum Hanif, pulmonologist at Advocate Christ Medical Center in Oak Lawn, Ill. “The data is compelling because we are seeing long-lasting, sustainable benefits for patients.”

Bronchial thermoplasty patients experienced no increase in hospitalizations, asthma symptoms or respiratory events over the course of five years, according to a study published in the Journal of Allergy and Clinical Immunology in December 2013.

People with severe asthma have an excess of smooth muscle lining their airways. An asthma attack occurs when some external trigger, such as pollen, cigarette smoke or cold air, prompts the muscle to constrict the airways, making breathing difficult, Dr. Hanif says.

The procedure is typically performed under moderate sedation in three hour-long sessions, each scheduled about three weeks apart.  During the procedure, a device consisting of a flexible tube with an array of electrodes at its tip is introduced into the patient’s lungs through a bronchoscope that is inserted through the nose or mouth.  In a matter of seconds, the electrodes deliver controlled radio frequency energy inside the airways.

“What’s important to understand is that bronchial thermoplasty does not replace daily medication for patients with severe asthma,” says Dr. Hanif. “Rather, the procedure works in conjunction with medication to significantly reduce the risk of asthma attacks.”

More than 20 million people in the U.S. have asthma and 5 to 10 percent of them have severe asthma, according to the Asthma and Allergy Foundation of America.  Each year, asthma attacks in this country account for an estimated 10 million outpatient visits, two million emergency room visits, 500,000 hospitalizations and 3,300 deaths.

Management of unstable asthma consumes more than $18 billion in health care resources annually.