To assess the effectiveness and safety of bronchial thermoplasty (BT)in the treatment of severe asthma.

The safety and effectiveness of BT were studied prospectively in 6 patients with poorly controlled severe asthma on long-term inhaled high-dose glucocorticoids and long-acting beta2-agonists in the First Affiliated Hospital of Guangzhou Medical University. Outcomes assessed after BT included asthma symptoms, frequency of acute exacerbations, pulmonary function, medication adjustment, and postoperative complications at 6 and 12 months after treatment.

The mini-AQLQ scores(6.4±0.5), the frequency of acute exacerbations[0.4(0.1-1.3)times/month], and the symptom-free days[(21.2±7.2)days/month] were significantly improved at 6 months after operation compared to those before operation[5.2±0.9, 2.0(0.9-4.0)times/month, (14.5±3.7)days/month, respectively, P<0.05]. Data collected at the 6^th month indicated significant improvements in the variation rate of PEF, the dose of inhaled glucocorticoids and oral glucocorticoids[(5.6±3.3)% vs.(21.1±7.8)%), (800±620)vs.(1 133±432) μg/d), 9.7(1.3-10.0) vs.15.0(10-20)mg/d, P<0.05]. Outcomes mentioned above were improved as well at the 12^th month. But the ACQ-6 scores, ACT scores, the ratio of PEF and its predicted value(%), the ratio of FVC and its predicted value(%), the ratio of FEV₁ and its predicted value(%)were not changed significantly (P>0.05). The PEF values and lung function measurements remained stable throughout the study period. The most common complications were cough (24.1%), wheezing(13.8%), followed by lower respiratory infection and atelectasis during the treatment. Pneumothorax and respiratory failure occurred in 1 patient 12 h after the third procedure.

Our preliminary study demonstrated promising effect of BT in the treatment of severe asthma, although there are some complications which need further observation.

Asthma; Therapeutics; Bronchial thermoplasty