Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, USA.
Care Analytics Department, Highmark Health, Pittsburgh, PA, USA.
J Asthma. 2024 Aug;61(8):867-875. doi: 10.1080/02770903.2024.2309532. Epub 2024 Feb 4.
Bronchial thermoplasty (BT) is an approved procedure to manage uncontrolled severe persistent asthma. Many insurance providers are reluctant to pay for BT without proven benefit among their specific patient panel.
Determine if BT is effective in a panel patient panel with uncontrolled severe persistent asthma.
This was an unblinded prospective study of adult subjects with uncontrolled severe persistent asthma who underwent BT. Outcomes were assessed at baseline and then 3-, 6-, 12-, 18- and 24-months post-BT. The primary metric was an improved Asthma Quality of Life Questionnaire (AQLQ) score. Other metrics included improved Asthma Control Test (ACT), peak expiratory flow rates (PEFR), spirometry, fractional excretion of nitric oxide (FeNO), number of unscheduled medical visits, and lost days of work/activity. Respiratory adverse events were assessed during the BT treatment period and at each post-BT visit.
Twenty-nine subjects completed the study; the median interquartile range (IQR) age was 47 (42-61), and the majority were female (69%), white (93%), and non-Hispanic (90%). After BT, mean (±std) AQLQ scores improved by 1.6(±1.1) at 3 months ( < 0.0001), 1.6(±1.2) at 6 months ( < 0.0001), 1.4(±1.0) at 12 months ( < 0.0001), 1.8(±1.1) at 18 months ( < 0.0001), and 1.6 (±1.5) at 24 months ( < 0.0001). There were significant improvements in ACT, PEFR, unscheduled medical visits and lost days of work and activity. Spirometry and FeNO metrics were unchanged. The average cost for subjects completing all 3 BT procedures was approximately $15,000.
BT is an effective adjunctive therapeutic modality in subjects with uncontrolled severe persistent asthma.
支气管热成形术（BT）是一种已获批准的治疗方法，用于治疗无法控制的严重持续性哮喘。许多保险公司不愿意为没有在其特定患者群体中证明获益的 BT 付费。
确定 BT 在无法控制的严重持续性哮喘的患者群体中是否有效。
这是一项针对接受 BT 治疗的成人患者的非盲前瞻性研究。在基线时和 BT 后 3、6、12、18 和 24 个月进行评估。主要指标是哮喘生活质量问卷（AQLQ）评分的改善。其他指标包括哮喘控制测试（ACT）、呼气峰流速（PEFR）、肺功能、一氧化氮呼出分数（FeNO）、非计划性医疗就诊次数和误工/失学天数的改善。在 BT 治疗期间和每次 BT 后就诊时评估呼吸不良事件。
29 名受试者完成了研究；中位数（四分位距 [IQR]）年龄为 47（42-61）岁，大多数为女性（69%）、白人（93%）和非西班牙裔（90%）。BT 后，平均（±标准差）AQLQ 评分在 3 个月时改善了 1.6（±1.1）（ < 0.0001），在 6 个月时改善了 1.6（±1.2）（ < 0.0001），在 12 个月时改善了 1.4（±1.0）（ < 0.0001），在 18 个月时改善了 1.8（±1.1）（ < 0.0001），在 24 个月时改善了 1.6（±1.5）（ < 0.0001）。ACT、PEFR、非计划性医疗就诊次数和误工/失学天数均有显著改善。肺功能和 FeNO 指标没有变化。完成所有 3 次 BT 程序的受试者的平均费用约为 15,000 美元。
BT 是治疗无法控制的严重持续性哮喘患者的有效辅助治疗方法。
