Bronchial Thermoplasty (BT) is for adult patients with Severe Asthma for whom medication, alone, isn't enough

Some patients still experience exacerbations and significantly limit their quality of life (assessed by AIS-6 or AQLQ), despite their recommended medication regimen.

These patients may benefit from Bronchial Thermoplasty to reduce their exacerbations. Fewer exacerbations may mean less need for the associated oral steroid treatment—and its side effects.

BT is for:

Patients on maximum tolerated doses of combined ICS and LABA such as Advair™, Dulera™ and Symbicort™, and who experience one or more of the following:

  • Take oral steroids for acute exacerbations more than twice a year
  • Anti-IgE therapy candidates or non-responders
  • Take oral steroids as daily maintenance medication

Societies support Bronchial Thermoplasty as a therapy for patients with Severe Asthma

ACAAI

"Scientific literature supports BT as a therapeutic consideration for some carefully chosen patients with severe asthma [...]"2

INTERASMA

"BT can offer an excellent alternative as an add-on therapy in severe asthma patients [...] BT should not be considered 'experimental'."3

CHEST

"We believe the literature supports BT as a therapeutic option for patients with severe asthma. We recommend that all public and private insurers provide coverage and payment for BT [...]"4

AAN

"AAN believes patients have the right to receive this therapy when their physician determines it is appropriate, and we urge health insurance payers to offer coverage."5

AAFA

"We would [not like] to see patients denied this treatment option, who cannot get their asthma well controlled with conventional therapy alone and who are fully insured."6

BT is included in asthma guidelines and strategy statements

BT Is Included In Asthma Guidelines And Strategy Statements
 
Who Benefits from BT?

Global asthma experts explain who benefits from BT

"There is a really positive experience when you see a patient and their asthma has changed because of this treatment."
— Robert Niven, MD
 

Global asthma experts explain how BT improves quality of life

"They get the freedom to resume some of the normal activities that most of us take for granted."
— Carla Lamb, MD
BT Improves Quality of Life

BT is not for patients who:

  • Are under 18 years old
  • Have a pacemaker, internal defibrillator, or other implantable electronic device
  • Have a known sensitivity to medications required to perform bronchoscopy, including lidocaine, atropine, and benzodiazepines
  • Have been treated previously with BT

Patients who chose BT to better manage their Severe Asthma

Brief Statement of Relevant Indications for Use, Contraindications, Warnings, and Adverse Events: The Alair™ Bronchial ThermoplastySystem is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Alair System is not for use in patients with an active implantable electronic device or known sensitivity to medications used in bronchoscopy. Previously treated airways of the lung should not be retreated with the Alair System. Patients should be stable and suitable to undergo bronchoscopy. The most common side effect of BT is an expected transient increase in the frequency and worsening of respiratory-related symptoms. ENDO-551804-AA

As with any procedure, there are risks, and individual results may vary. The most common adverse event of BT is a temporary worsening of respiratory-related symptoms. These events typically occur within one day of the BT procedure and usually resolve within a week with standard care. There is a small risk (3.4% per procedure) that symptoms may require hospitalization.14

References

  1. Adapted from the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2014. Available from: https://www.ginasthma.org/.
  2. American College of Asthma, Allergy and Immunology (ACAAI). Statement On Bronchial Thermoplasty. May 2015.
  3. INTERASMA (Global Asthma Association). Bronchial Thermoplasty: An Additional Option for Managing Patients with Severe Asthma. October 2014
  4. CHEST American College of Chest Physicians. Position Statement for Coverage and Payment for Bronchial Thermoplasty. May 12, 2014
  5. Allergy & Asthma Network (AAN). Bronchial Thermoplasty. June 2015
  6. Asthma Allergy Foundation of America (AAFA). Patient Advocacy Support for Full Medical Coverage for Bronchial Thermoplasty (BT) to Treat Severe Asthma. 2009
  7. From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2015. May 19, 2015
  8. GEMA4.0. Guía española para el manejo del asma © 2015, Comité Ejecutivo de la GEMA. Todos los derechos reservados ISBN: 978-84-7989-840-3. Depósito legal: M-13523-2015.
  9. Associazione Italiana Pneumologi Ospedalieri (AIPO). Rassegna di Patologia dell'Apparato Respiratorio - fascicolo 1/2015.
  10. British Thoracic Society (BTS). British guideline on the management of asthma. October 2014.
  11. Kian Fan Chung et al: International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014; 43: 343–373 | DOI: 10.1183/09031936.00202013
  12. Wechsler ME and Cox GP. Letter to Editor. Eur Respir J. 2014; 44: 267 | DOI: 10.1183/09031936.00043514
  13. Kian Fan Chung, Sally E. Wenzel and Jan L. Brozek for the ERS/ATS Task Force on Definition, Evaluation and Treatment of Severe Asthma. Response to Letter to Editor. Eur Respir J. 2014; 44: 267–268 | DOI: 10.1183/09031936.00064614
  14. Castro M, et al, for the AIR2 Trial Study Group. Am J Respir Crit Care Med. 2010;181:116-124.
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