Bronchial thermoplasty for severe uncontrolled asthma in Japan.

Published on Jul 1, 2017in Allergology International4.806
· DOI :10.1016/J.ALIT.2017.07.006
Motoyasu Iikura21
Estimated H-index: 21
,
Masayuki Hojo11
Estimated H-index: 11
+ 7 AuthorsHaruhito Sugiyama19
Estimated H-index: 19
Sources
Abstract
📖 Papers frequently viewed together
727 Citations
2020
7 Authors (M. Iikura, ..., H. Sugiyama)
2014
1 Author (Mark Sands)
References10
Newest
#1David Langton (Monash University)H-Index: 12
#2Joy Sha (Frankston Hospital)H-Index: 5
Last. Erica M. Wood (Monash University)H-Index: 31
view all 5 authors...
Background Bronchial thermoplasty is an approved bronchoscopic intervention for the treatment of severe asthma. However, limited published experience exists outside of clinical trials regarding patient selection and outcomes achieved. Aims To evaluate the effectiveness and safety of bronchial thermoplasty in patients with severe asthma encountered in clinical practice. Methods This is a retrospective analysis of the first ‘real world’ data from Australia. The following outcomes were measured pri...
12 CitationsSource
#1Masakazu Ichinose (Tohoku University)H-Index: 19
#1Masakazu Ichinose (Tohoku University)H-Index: 28
Last. Ken OhtaH-Index: 53
view all 11 authors...
Abstract Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and...
91 CitationsSource
#1Marina Pretolani (French Institute of Health and Medical Research)H-Index: 3
#1Marina Pretolani (Paris Diderot University)H-Index: 10
Last. Michel AubierH-Index: 67
view all 11 authors...
Background The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma, yet its effect on different bronchial structures remains unknown. Objective We sought to examine the effect of BT on bronchial structures and to explore the association with clinical outcome in patients with severe refractory asthma. Methods Bronchial biopsy specimens (n = 300) were collected from 15 patients with severe uncontrolled asthma before and 3 months after BT. Immunostained sec...
97 CitationsSource
#1Jamila Chakir (Laval University)H-Index: 40
#2Ikhlass Haj-Salem (Laval University)H-Index: 1
Last. Michel LavioletteH-Index: 64
view all 11 authors...
Rationale: The aim of bronchial thermoplasty is to improve asthma symptoms by reducing central airway smooth muscle mass. Up to now, the reduction of smooth muscle mass has been documented for only 1 group of 10 patients who had 15% or more of their pretreatment total bronchial biopsy area occupied by smooth muscle.Objectives: To evaluate the effects of bronchial thermoplasty on airway smooth muscle mass and airway collagen deposition in adult patients with asthma, regardless of pretreatment smo...
79 CitationsSource
#1Marina Pretolani (French Institute of Health and Medical Research)H-Index: 10
Last. Michel AubierH-Index: 67
view all 9 authors...
98 CitationsSource
#1Michael E. Wechsler (University of Colorado Denver)H-Index: 55
#2Michel Laviolette (Laval University)H-Index: 64
Last. Mario Castro (WashU: Washington University in St. Louis)H-Index: 85
view all 34 authors...
Background Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma. Objective We sought to assess the effectiveness and safety of BT in asthmatic patients 5 years after therapy. Methods BT-treated subjects from the Asthma Intervention Research 2 trial (ClinicalTrials.gov NCT01350414) were evaluated annually for 5 years to assess the long-term safety of BT and the durability of its treatment effect. Outcomes assessed...
195 CitationsSource
Rationale: Bronchial thermoplasty (BT) is a bronchoscopic procedure in which controlled thermal energy is applied to the airway wall to decrease smooth muscle.Objectives: To evaluate the effectiveness and safety of BT versus a sham procedure in subjects with severe asthma who remain symptomatic despite treatment with high-dose inhaled corticosteroids and long-acting β2-agonists.Methods: A total of 288 adult subjects (Intent-to-Treat [ITT]) randomized to BT or sham control underwent three broncho...
89 CitationsSource
#1Mario Castro (WashU: Washington University in St. Louis)H-Index: 85
Last. Gerard Cox (McMaster University)H-Index: 50
view all 28 authors...
Rationale: Bronchial thermoplasty (BT) is a bronchoscopic procedure in which controlled thermal energy is applied to the airway wall to decrease smooth muscle. Objectives: To evaluate the effectiveness and safety of BT versus a sham procedure in subjects with severe asthma who remain symptomatic despite treatment with high-dose inhaled corticosteroids and long-acting β2-agonists. Methods: A total of 288 adult subjects (Intent-to-Treat [ITT]) randomized to BT or sham control underwent three bronc...
727 CitationsSource
#1Ian D. Pavord (University Hospitals of Leicester NHS Trust)H-Index: 117
#2Gerard CoxH-Index: 50
Last. Michel LavioletteH-Index: 64
view all 8 authors...
Rationale: Bronchial thermoplasty (BT) is designed to reduce airway smooth muscle and improve asthma control.Objectives: This study was conducted to determine the safety and efficacy of this procedure in subjects with symptomatic, severe asthma.Methods: Adults who were symptomatic despite treatment with fluticasone or equivalent at more than 750 μg/day, a long-acting β2-agonist, and other medications, which could include 30 mg or less of oral prednisolone/day, were randomized to BT or to a contr...
412 CitationsSource
#1Gerard Cox (McMaster University)H-Index: 50
#2Neil C. ThomsonH-Index: 72
Last. Michel LavioletteH-Index: 64
view all 12 authors...
Background Bronchial thermoplasty is a bronchoscopic procedure to reduce the mass of airway smooth muscle and attenuate bronchoconstriction. We examined the effect of bronchial thermoplasty on the control of moderate or severe persistent asthma. Methods We randomly assigned 112 subjects who had been treated with inhaled corticosteroids and long-acting β2-adrenergic agonists (LABA) and in whom asthma control was impaired when the LABA were withdrawn to either bronchial thermoplasty or a control g...
656 CitationsSource
Cited By15
Newest
#1Shinji SasadaH-Index: 16
#2Kenshiro OhmuraH-Index: 1
Last. Masahiro KajiH-Index: 20
view all 10 authors...
Fungal infections are rarely reported as a complication of bronchial thermoplasty (BT) in patients without immunosuppressive comorbidity. A 19-year-old woman college student was admitted to our hospital owing to uncontrolled severe asthma despite using the maximum dose of steroid inhalation. She experienced asthmatic attacks more frequently while cheerleading, which is an extracurricular activity. She received BT because she wanted to continue cheerleading. After the second BT session, she devel...
Source
#1Raja Dhar (Fortis Healthcare)H-Index: 8
#2Mary Ip (HKU: University of Hong Kong)H-Index: 1
Last. Mariko Siyue Koh (SGH: Singapore General Hospital)H-Index: 18
view all 8 authors...
Asthma imposes a significant burden on the health system and patients' quality of life. Within Asia, there is large variability in several cultural, social and economic factors ultimately influencing the management of asthma. Differences in risk factors and asthma management practices across Asia make asthma a truly 'mixed-bag' phenomenon. With the advent of biological agents and the consequent emphasis on asthma phenotyping and endotyping, it is more important than ever to understand the divers...
Source
Source
Source
#1Haruhito SugiyamaH-Index: 19
#2Motoyasu IikuraH-Index: 1
Last. Masayuki HojoH-Index: 11
view all 4 authors...
Bronchial Thermoplasty (BT) is an epoch-making treatment that reduces bronchial smooth muscle by using a bronchoscope to reach the basket catheter to the bronchus and directing high-frequency current directly into the bronchi. In GINA Guidelines 2019, BT is considered to be additional treatment at Step V (the most severe), and the evidence level is B. The Japanese guidelines (JGL) also added BT as a treatment for Step 4, but it is reserved because there are still unclear points regarding long-te...
Source
#1Neil C. Thomson (Glas.: University of Glasgow)H-Index: 72
Purpose Bronchial thermoplasty is approved in many countries worldwide as a non-pharmacological treatment for severe asthma. This review summarizes recent publications on the selection of patients with severe asthma for bronchial thermoplasty, predictors of a beneficial response and developments in the procedure and discusses specific issues about bronchial thermoplasty including effectiveness in clinical practice, mechanism of action, cost-effectiveness, and place in management.
5 CitationsSource
#1Shota Yamamoto (Tokai University)H-Index: 4
#2Motoyasu IikuraH-Index: 21
Last. Haruhito SugiyamaH-Index: 19
view all 17 authors...
Introduction Bronchial thermoplasty (BT) is a bronchoscopic procedure that involves the delivery of thermal radiofrequency energy to the bronchial wall for treating severe asthma. It has been suggested that too many radiofrequency activations could induce serious adverse events (SAEs) at an early stage. We aimed to examine the number of radiofrequency activations at each session and early lung function changes from baseline to determine whether these are related to SAEs.
2 CitationsSource
#1Sachi MatsubayashiH-Index: 2
#2Motoyasu IikuraH-Index: 21
Last. Haruhito SugiyamaH-Index: 19
view all 5 authors...
: Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma. A 35-year-old woman with uncontrolled severe asthma despite maximal pharmacological treatment underwent BT and started coughing after the first procedure. One month later, during the second BT procedure, there were white ulcerous lesions on the right B9 bronchus. Culture of the bronchial brushing specimen showed Aspergillus fumigatus, for which voriconazole was started for treatment. On the third BT procedure, endobron...
3 CitationsSource
#1Takashi Iwanaga (Kindai University)H-Index: 14
#2Akiko Sano (Kindai University)H-Index: 9
Last. Yuji Tohda (Kindai University)H-Index: 22
view all 5 authors...
In the approximately 5–10% of asthma patients whose condition is poorly controlled, asthma is present even if the patient is treated with high-dose inhalational steroids and long-acting beta 2 agonists. We cauterized a bronchus of 3–10 mm inner diameter at 65 °C for patients with such severe asthma. Bronchial thermoplasty, which reduces the quantity of the airway smooth muscle, was introduced as an epoch-making treatment in Japan from 2015. Airway contraction is reduced through the reduction of ...
Source
#1Satoru IshiiH-Index: 6
#2Motoyasu IikuraH-Index: 21
Last. Haruhito SugiyamaH-Index: 19
view all 6 authors...
: Bronchial thermoplasty (BT) is a bronchoscopic treatment to reduce the amount of smooth muscle in the bronchial wall in patients with severe asthma. Reducing smooth muscle in the airway wall reportedly alleviates air trapping and decreases expiratory volume. In the current study, expiratory computed tomography (CT) was performed in 10 patients who underwent BT at our facility, and their expiratory volume was evaluated. We observed an improvement in the expiratory volume on CT in nine of the 10...
3 CitationsSource