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Open Access Highly Accessed Research article

Long-term (5 year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial

Neil C Thomson*, Adalberto S Rubin, Robert M Niven, Paul A Corris, Hans Christian Siersted, Ronald Olivenstein, Ian D Pavord, David McCormack, Michel Laviolette, Narinder S Shargill, Gerard Cox and the AIR Trial Study Group

BMC Pulmonary Medicine 2011, 11:8  doi:10.1186/1471-2466-11-8

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Does the benifit last for one year only?

Prince James   (2011-07-22 17:25)  Pulmonary Medicine,Christian Medical College, Vellore email

I read with interest the results of 5 year follow up of Bronchial thermoplasty (BT) cases of AIR1 trial1. Health care utilization events, Oral corticosteroid use, Maintenance asthma medication use, Pulmonary function tests results were similar in patient and control group in 2nd an 3rd year post BT. Only difference was significant improvement in Methacholine PC20 in BT group. There is no comment on changes in Asthma quality of life questionnaire score (AQLQ) and Asthma control questionnaire (ACQ)score, which were the only important outcomes in Bronchial thermoplasty trials (RISA, AIR1 and AIR2)2,3,4. Till date, BT failed to produce any significant improvement in FEV1 values of Asthma patients. The AIR1, AIR2 and RISA trials showed that BT provides some significant improvement in AQLQ and ACQ scores. But this 5 year post BT follow up study results showed that one year after BT, both BT patients and control group are similar in all parameters1. And Improvement for one year in AQLQ and ACQ scores comes at the cost of significant increase in asthma symptoms and hospitalizations in initial 6 weeks after BT. How much justified it will be to subject our asthma patients to the risk of increased symptoms and and hospitalization in initial 6 weeks post BT, when after one year post BT, their asthma control will same as control group.

References :
1. Thomson NC, Rubin AS, Niven RM, Corris PA, Siersted HC et al. Long term (5 year) safety of bronchial thermoplasty: Asthma Intervention research (AIR) trial. BMC Pulmonary Medicine 2011,11:8
2. Pavord ID, Cox G, Thomson NC, Rubin AS et al. Safety and Efficacy of bronchial thermoplasty in symptomatic, severe asthma. Am J Respir Crit Care Med 2007;176: 1185 -1191
3. CoxG, Thomson NC, Rubin AS, Niven RM, Corris PA et al. Asthma control during the year after Bronchial thermoplasty. N Engl J Med 2007;356: 1327 -37.
4. Castro M, Rubin AS, Laviolette M, Filterman J, Lima MDA et al. Effectiveness and safety of Bronchial thermoplasty in the treatment of severe asthma. Am J Respir Crit Care Med 2010;181: 116 -124.

Competing interests

There is no competing interest.

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