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| |  Bronchial Thermoplasty for Severe Asthma Opens Airways and Improves Quality of Life: Presented at AAAAI By Em Brown WASHINGTON, DC -- March 18, 2009 -- A technique to reduce bronchial airway muscle mass results in clinically meaningful improvements in asthma control and quality of life in patients with severe and persistent asthma, according to study results reported here at the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting. Robert M. Niven, MD, North West Lung Center, Wythenshawe Hospital and University of Manchester, Manchester, United Kingdom, and colleagues in Brazil, Canada, and Denmark presented their results on March 16. At enrolment, patients in the Asthma Intervention Research trial were receiving a beclomethasone dose of at least 200 mcg or an equivalent inhaled corticosteroid (ICS) and were receiving a long-acting beta2 agonist (LABA) for asthma control. Patients were randomised to standard of care or to standard of care plus thermoplasty performed using the Alair Bronchial Thermoplasty System with 3 specific 2-week periods where LABA therapy was withdrawn. Researchers administered the Asthma Quality of Life Questionnaire (AQLA) before the intervention and after 3, 6, and 12 months. Patients discontinued use of their LABA therapy 2 weeks prior to completing the questionnaire, so that at the time of completion they were being maintained on the ICS alone. Of the 55 patients randomised to thermoplasty, 35 (63.6%) showed a response to intervention. At 3 months, 68% of patients in the thermoplasty group had an improvement in asthma symptoms compared with 22% of control patients. Improvement was seen in 69% of thermoplasty patients at 6 months compared with 39% of control patients, at 12 months, thermoplasty resulted in improvement among 80% of patients compared with 43% with standard of care. The difference in true benefit between thermoplasty and controls was 46% at 3 months, 30% at 6 months, and 37% at 12 months, the researchers said. A change of 0.5 points on the AQLQ was considered a clinically meaningful change, Dr. Niven reported. There was a 1.61-point improvement in AQLQ score compared with no change in controls at 12 months. Use of rescue medications at 12 months decreased by 12.24% and 1.17%, respectively, and symptom-free days increased by 50% and 17%, respectively. Morning peak expiratory flow rates at 12 months were 40.33 and 8.53 L/min in the 2 treatment groups, respectively. "The analysis of data for bronchial thermoplasty responders based on AQLQ score demonstrated that more patients with bronchial thermoplasty achieved clinically meaningful improvements compared to control subjects in not only AQLQ scores, but in other key measures of asthma control compared with control subjects," Dr. Niven said. [Presentation title: Responder Analysis of AQLQ in the Asthma Intervention Research (AIR) Trial. Abstract 7]
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