|This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.|
The use of bronchial thermoplasty (BT) resulted in improvements in asthma control and reductions in the use of corticosteroid maintenance therapies during the course of 5 years in patients with asthma, according to research presented at the 2020 CHEST Annual Meeting, held virtually October 18 to 21.
The findings presented were from the prospective, open-label PAS2 study (Bronchial Thermoplasty in Severe Persistent Asthma; ClinicalTrial.gov Identifier: NCT01350336) conducted at sites in the United States and Canada. In total, 284 patients with asthma (age range, 18-65 years) from 27 centers were enrolled. All patients were taking inhaled corticosteroids (ICS; beclomethasone or equivalent; ≥1000 µg/d) and long-acting beta-agonists (LABA; salmeterol or equivalent; ≥80 µg/d).
Health care utilization, including severe exacerbations, hospitalization, and emergency department visits were analyzed. Spirometry values, including FEV1 and forced vital capacity (FVC), and medication usage through 5 years after treatment were evaluated.
A total of 279 patients had at least 1 of the 3 BT procedures, whereas 271 had all 3 BT procedures. The mean age at baseline was 45.7 years, mean body mass index was 32.2, and the mean AQLQ was 4.03. Full 5-year follow-up data were available for 227 patients.
The proportion of patients with severe exacerbations at 12 months before BT and at 1, 2, 3, 4, and 5 years after BT were 78%, 50%, 47%, 47%, 44%, and 43%, respectively. The investigators found similar patterns in hospitalizations and emergency department visits for asthma.
The mean ICS dose decreased from a baseline value of 2272 µg per day to between 1910 and 2080 µg per day for years 1 through 5 after BT. Additionally, the proportion of patients at baseline who were using maintenance oral corticosteroids was 19.4%, which decreased to 8.1% to 10.7% during years 1 through 5, respectively.
From baseline to year 5, the use of omalizumab decreased from 16% to 11%, respectively. Mepolizumab and benralizumab use increased to 6.6% and 0.9%, respectively at 5 years. The FEV1 and FVC was stable following BT treatment. Furthermore, the safety of BT persisted at 5 years.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
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Chupp G, Kline J, Khatri S, et al. Long-term efficacy and safety of bronchial thermoplasty: 5-year follow-up results from a large-scale prospective study. Presented at: the CHEST Virtual Annual Meeting; October 18-21, 2020. Abstract 12.