title: Bronchial thermoplasty for severe asthma.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Infection, Immunity and Inflammation, University of Glasgow & Respiratory Medicine, Gartnavel General Hospital, Glasgow, UK. neil.thomson@glasgow.ac.uk
authors.forename: Neil C
authors.initials: NC
authors.lastname: Thomson
authors.forename: Stephen
authors.initials: S
authors.lastname: Bicknell
authors.forename: Rekha
authors.initials: R
authors.lastname: Chaudhuri
mesh_terms: D001249:Asthma / Q000503:physiopathology / Q000601:surgery*; D001980:Bronchi / Q000601:surgery; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome