No Thermoplasty for Steve

Ive been getting a lot of email lately from people asking me if I’m gonna have the new Bronchial Thermoplasty procedure done. The answer is No. Unfortunately, my asthma is too severe even for the thermoplasty ,which is being touted as a treatment reserved for the most severe form of asthma …go figure. Actually, I don’t have a lot of the reactive smooth muscle in my larger airways that Thermoplasty targets. Most of my airway narrowing takes place deep down in my lungs in the smaller airways, where they cant reach with this device.

Hopefully this new treatment will help a few people, but I’m not convinced that this is the magic bullet that we’ve all been waiting for. It also seems that the company’s definition of “very severe asthma”, is somewhat different than my own. Ironically, I was denied entry into the clinical trials phase of this new procedure back in 2006, because my asthma was deemed “too severe” by the study investigators.

People with very severe chronic asthma usually have a fair amount of scarring, and some have less twitchiness in their large airways. It would seem to me, that this new procedure has a better chance of success on those individuals who have mild to moderate persistent asthma, whose primary problem is spastic airways and who don’t have a lot of airway remodeling. Although in both cases, inflammation can play a significant role in asthma and its symptoms. Bronchial thermoplasty is not known to do anything to inflammation.

Even if I was a suitable candidate for the procedure, I’m not really sure I’d want to have it done. There just hasn’t been enough research on it in the real world, and any scientific proof that it actually works, is marginal at best. Now that this device is approved for use in the US, I think it would be wise to wait a while and see what the outcomes will be like.

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6 Comments

  1. Amy, that is true, it might open up some more no drug options. Which would be good.

    Steve, your knowledge about asthma is amazing. I have to remind myself that you have had this for your whole life and I have only had it for three years, so of course you know more than me.

    The last asthma attack that landed me in the hospital, back in February, left me with a permanent sort of wheeze thing. I am not sure what that means for the future. I guess it does not really matter, either my asthma will keep getting worse or it won't.

  2. Steve Gupta, M.D. says:

    The company conducted a trial, called AIR trial. The FDA approval was based on this trial. The company excluded all of the more severe asthmatics from this study. However FDA approved this device for use only in severe asthmatics!!

  3. POP says:

    My sentiments exactly! I have the small airway thing too, so I suspect you may be right, thermoplasty is not our salvation.

    M

    • Not sure why they call it thermoplasty in the first place, because the \”plasty\” implies some sort of repair. Thermoplasty doesn\’t repair the smooth muscle, it heats it up and burns it.
      The more I read about it, the less I like it. The clinical trials of this procedure were flawed from the very start. I think the FDA made a huge mistake by signing off on it so quickly.
      I guess time will tell. Hopefully it will help a few people, but I wouldn\’t bet on it.

  4. DeDe says:

    Well I was so happy to hear of anything that would help me have better days
    So I did decide to have it done, went in for my first treatment and woke up
    A hour later to find out nothing was done,, I had troubles with being put to
    Sleep low heart rate and low oxygen level, so my family wasn’t for it to begin
    With so I won’t be going back.. I have lived with asthma all my life and now
    I’m disabled with lung disease .. This is the first time I had heard that some
    Can’t have the BT done because they are to severe.. I would think I wasn’t a
    Candidate. So before anyone jumps in make sure you research and let your family
    Help you decide. It really scared my kids ,hubby an myself . I just was so ready
    To feel normal for once . I will just continue living like this.

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