Bronchial thermoplasty for severe asthmaThomson, Neil C.; Bicknell, Stephen; Chaudhuri, RekhaCurrent Opinion in Allergy & Clinical Immunology: June 2012 - Volume 12 - Issue 3 - p 241–248 doi: 10.1097/ACI.0b013e32835335ca OUTCOME MEASURES: Edited by Henry Milgrom and Ralph Mosges Abstract Author Information Purpose of review: Bronchial thermoplasty, which involves the delivery of radio frequency energy to the airways to reduce airway smooth muscle mass, has been recently introduced for the treatment of severe asthma. This review summarizes the preclinical development, efficacy and adverse effects of bronchial thermoplasty. In addition, the potential mechanisms of action and place in management of severe asthma are discussed. Recent findings: The efficacy and adverse profile of bronchial thermoplasty has been assessed in three randomized controlled trials, the first two of which showed clinical benefits of bronchial thermoplasty compared with usual care in patients with moderate or severe asthma. The third trial reports the results of a comparison with sham bronchial thermoplasty in 288 adults with severe asthma. Bronchial thermoplasty improved asthma quality of life questionnaire scores compared with sham bronchial thermoplasty; in the posttreatment period, there were fewer severe exacerbations and emergency department visits. Bronchial thermoplasty causes short-term increases in asthma-related morbidity. Follow-up data to date support the long-term safety of the procedure. Summary: Bronchial thermoplasty has a role in the management of patients with severe asthma who have uncontrolled symptoms despite current therapies. Future studies need to identify factors that predict a beneficial clinical response. Institute of Infection, Immunity and Inflammation, University of Glasgow & Respiratory Medicine, Gartnavel General Hospital, Glasgow, UK Correspondence to Professor Neil C. Thomson, Institute of Infection, Immunity and Inflammation, University of Glasgow & Respiratory Medicine, Gartnavel General Hospital, Glasgow G12 OYN, UK. Tel: +44 141 211 3241; fax: +44 141 211 3464; e-mail: firstname.lastname@example.org Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.