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Review

Bronchial thermoplasty as a treatment for severe asthma: controversies, progress and uncertainties

Pages 269-282 | Received 04 Jan 2018, Accepted 21 Feb 2018, Published online: 27 Feb 2018
 

ABSTRACT

Introduction: Bronchial thermoplasty is a licensed non-pharmacological treatment for severe asthma.

Area covered: This article considers evidence for the efficacy and safety of bronchial thermoplasty from clinical trials and observational studies in clinical practice. Its place in the management of severe asthma, predictors of response and mechanisms of action are reviewed.

Expert commentary: Bronchial thermoplasty improves quality of life and reduces exacerbations in moderate to severe asthma. Morbidity from asthma is increased during treatment. Overall, patients treated in clinical practice have worse baseline characteristics and comparable clinical outcomes to trial data. Follow-up studies provide reassurance on long-term safety. Despite some progress, future research needs to investigate uncertainties about predictors of response, mechanism of action and place in management of asthma.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, or options, expert testimony, grants or patents received or pending, or royalties. A reviewer on this manuscript has disclosed that they have served as a consultant to Boston Scientific. They have also received unrestricted education grants from, have lectured on behalf of, and have conducted sponsored research for Boston Scientific. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Declaration of interest

No potential conflict of interest was reported by the author.

Additional information

Funding

This manuscript has not been funded.

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