Patients with severe asthma may get the relief they need with bronchial thermoplasty, a procedure that involves the delivery of controlled, therapeutic radiofrequency energy to the body's airway wall, heating the tissue and reducing the amount of smooth muscle present in the airway wall.
In a clinical study of bronchial thermoplasty, adults with severe asthma who were treated with bronchial thermoplasty had improved asthma-related quality of life up to a year after the procedure compared to the control patients.
Young Ko, MD, is here to discuss while many people with asthma can control their symptoms with antiinflammatory therapies and avoiding triggers, some cannot. For these patients, there is new hope that goes hand-inhand with a treatment called bronchial thermoplasty
Selected Podcast
Severe Asthma Treatment with Bronchial Thermoplasty
Featured Speaker:
Learn more about Young Ko, MD
Young Ko, MD
Young Ko, MD, is board certified in Internal and Pulmonary Medicine with Palmdale Regional Medical Center.Learn more about Young Ko, MD
Transcription:
Severe Asthma Treatment with Bronchial Thermoplasty
Melanie Cole (Host): Patients with severe asthma may get the relief they need with bronchial thermoplasty. My guest today is Dr. Young Ko. He's a pulmonologist and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Dr. Ko. Tell us a little bit about bronchial thermoplasty and how it can help patients with severe asthma.
Dr. Young Ko (Guest): Bronchial thermoplasty is a treatment for severe asthma approved
by the FDA in 2010. In this country, asthma affects about 25 million in the population. So, for severe asthma, 5-10% of them, they are not responding well to conventional medication treatment for asthma. So, when bronchial thermoplasty came out, it showed a very detectable, safe treatment for this severe asthma patient. Through the bronchoscopy, we put the special catheter. This catheter delivers the radiofrequency heat energy to the bronchial wall. By doing this, they are reducing the smooth muscle thickness in the bronchial wall. By doing that, they control the asthma well. This smooth muscle actually causes the pulpal contusion during the asthma attack and shuts down the air passages. So, this bronchial thermoplasty is, basically, very effective. So far, 5-year studies show the steady, effective treatment.
Melanie: So then, what's involved in it? What is it?
Dr. Ko: The patient has to come to the hospital in several different sessions with the bronchoscopy in the operating room or either the sedation room and then, through the bronchoscopy, we put a special catheter. This catheter delivers the radiofrequency heat energy to the bronchial wall. By delivering heat energy, they decrease the smooth muscle thickness in the bronchial wall. By doing that, they control the asthma well.
Melanie: And, how well do patients tolerate this?
Dr. Ko: Patients tolerate this very well. So far, nationwide and internationally, nobody has died of this procedure. It's a safe procedure and, actually, also the treatment result so far the 5-year study, it came out very impressive, as a matter of fact.
Melanie: So, just give us a little lesson about what happens during an asthma attack, Dr. Ko.
Dr. Ko: During an asthma attack, the patient is very short of breath, the chest tightens. They are missing from the school or work. They can't perform their normal, daily activities. There are many medications that control asthma well, but, so far, not the severe asthma. So, for 5-10% of asthma population, they are not responding well to medication treatment, so new treatment needs to be developed. That's why bronchial thermoplasty was developed. It was approved by FDA in 2010 and, in the last three years, we've been doing bronchial thermoplasty in Palmdale Hospital. So far, patients are very happy with the effectiveness.
Melanie: And does this reduce asthma attacks so that they have fewer needs for oral steroid treatments and the side effects of those?
Dr. Ko: Yes, exactly. That's what they're doing. By doing these treatments, the requirement of asthma medication is much less and also there's a study. I can quote the data. "The 5-year data so far shows a 32% reduction in asthma attacks after bronchial thermoplasty; 84% reduction in emergency room visits; a 66% reduction in missing school and work; and a 73% reduction in hospitalization from asthma attacks." So, very impressive so far.
Melanie: And, can it complement the current treatment to help with the quality of life? Is it one or the other? Can they work together?
Dr. Ko: They work together. Even though you are doing bronchial thermoplasty, you still have to continue the bronchodilator medication. So, they work together and complement each other. They control the asthma better.
Melanie: Are there some people, Dr. Ko, who are not candidates for bronchial thermoplasty?
Dr. Ko: There's no absolute contraindication for bronchial thermoplasty but, in some cases, like a patient with COPD and also bronchiectasis, some cases we have to be more careful, but usually, this is mainly for the severe asthma population not responding to medication treatment.
Melanie: And, how long does this last? Is it something that they have to come back in and do again?
Dr. Ko: So far, studies don't show the history in particular, but so far, studies like the one-year study came out with really impressive results, but the five-year study recently came out, that the benefits were sustained for five years. So, you may go more than five years, but the study data is not available at this point.
Melanie: Does it affect the actual asthma attack as they happen? I mean, you can still get an asthma attack after this procedure, yes? But, just not as many?
Dr. Ko: That's correct. Much less and also the requirement of a bronchial dilator instead of the inhaler treatment is much less after having this treatment.
Melanie: What about the severity of the actual asthma attack? Is that reduced?
Dr. Ko: That's correct also. The severity is reduced.
Melanie: Wow, that's absolutely amazing. In just the last few minutes, Dr. Ko, give people with severe asthma your best advice about severe asthma and bronchial thermoplasty.
Dr. Ko: So, this bronchial thermoplasty is mainly for the adult population and the severe asthma patient not responding to usual medication such as bronchial dilators and steroids. They should consider this bronchial thermoplasty. It's a safe, effective procedure.
Melanie: And then, tell us why should they come to Palmdale Regional Medical Center for their care?
Dr. Ko: At this point, Palmdale Hospital is the only hospital that has bronchial thermoplasty in this area.
Melanie: Wow, that's absolutely fascinating. Thank you so much for being with us. You're listening to Palmdale Regional Radio. For more information, you can go to palmdaleregional.com. That's palmdaleregional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Severe Asthma Treatment with Bronchial Thermoplasty
Melanie Cole (Host): Patients with severe asthma may get the relief they need with bronchial thermoplasty. My guest today is Dr. Young Ko. He's a pulmonologist and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Dr. Ko. Tell us a little bit about bronchial thermoplasty and how it can help patients with severe asthma.
Dr. Young Ko (Guest): Bronchial thermoplasty is a treatment for severe asthma approved
by the FDA in 2010. In this country, asthma affects about 25 million in the population. So, for severe asthma, 5-10% of them, they are not responding well to conventional medication treatment for asthma. So, when bronchial thermoplasty came out, it showed a very detectable, safe treatment for this severe asthma patient. Through the bronchoscopy, we put the special catheter. This catheter delivers the radiofrequency heat energy to the bronchial wall. By doing this, they are reducing the smooth muscle thickness in the bronchial wall. By doing that, they control the asthma well. This smooth muscle actually causes the pulpal contusion during the asthma attack and shuts down the air passages. So, this bronchial thermoplasty is, basically, very effective. So far, 5-year studies show the steady, effective treatment.
Melanie: So then, what's involved in it? What is it?
Dr. Ko: The patient has to come to the hospital in several different sessions with the bronchoscopy in the operating room or either the sedation room and then, through the bronchoscopy, we put a special catheter. This catheter delivers the radiofrequency heat energy to the bronchial wall. By delivering heat energy, they decrease the smooth muscle thickness in the bronchial wall. By doing that, they control the asthma well.
Melanie: And, how well do patients tolerate this?
Dr. Ko: Patients tolerate this very well. So far, nationwide and internationally, nobody has died of this procedure. It's a safe procedure and, actually, also the treatment result so far the 5-year study, it came out very impressive, as a matter of fact.
Melanie: So, just give us a little lesson about what happens during an asthma attack, Dr. Ko.
Dr. Ko: During an asthma attack, the patient is very short of breath, the chest tightens. They are missing from the school or work. They can't perform their normal, daily activities. There are many medications that control asthma well, but, so far, not the severe asthma. So, for 5-10% of asthma population, they are not responding well to medication treatment, so new treatment needs to be developed. That's why bronchial thermoplasty was developed. It was approved by FDA in 2010 and, in the last three years, we've been doing bronchial thermoplasty in Palmdale Hospital. So far, patients are very happy with the effectiveness.
Melanie: And does this reduce asthma attacks so that they have fewer needs for oral steroid treatments and the side effects of those?
Dr. Ko: Yes, exactly. That's what they're doing. By doing these treatments, the requirement of asthma medication is much less and also there's a study. I can quote the data. "The 5-year data so far shows a 32% reduction in asthma attacks after bronchial thermoplasty; 84% reduction in emergency room visits; a 66% reduction in missing school and work; and a 73% reduction in hospitalization from asthma attacks." So, very impressive so far.
Melanie: And, can it complement the current treatment to help with the quality of life? Is it one or the other? Can they work together?
Dr. Ko: They work together. Even though you are doing bronchial thermoplasty, you still have to continue the bronchodilator medication. So, they work together and complement each other. They control the asthma better.
Melanie: Are there some people, Dr. Ko, who are not candidates for bronchial thermoplasty?
Dr. Ko: There's no absolute contraindication for bronchial thermoplasty but, in some cases, like a patient with COPD and also bronchiectasis, some cases we have to be more careful, but usually, this is mainly for the severe asthma population not responding to medication treatment.
Melanie: And, how long does this last? Is it something that they have to come back in and do again?
Dr. Ko: So far, studies don't show the history in particular, but so far, studies like the one-year study came out with really impressive results, but the five-year study recently came out, that the benefits were sustained for five years. So, you may go more than five years, but the study data is not available at this point.
Melanie: Does it affect the actual asthma attack as they happen? I mean, you can still get an asthma attack after this procedure, yes? But, just not as many?
Dr. Ko: That's correct. Much less and also the requirement of a bronchial dilator instead of the inhaler treatment is much less after having this treatment.
Melanie: What about the severity of the actual asthma attack? Is that reduced?
Dr. Ko: That's correct also. The severity is reduced.
Melanie: Wow, that's absolutely amazing. In just the last few minutes, Dr. Ko, give people with severe asthma your best advice about severe asthma and bronchial thermoplasty.
Dr. Ko: So, this bronchial thermoplasty is mainly for the adult population and the severe asthma patient not responding to usual medication such as bronchial dilators and steroids. They should consider this bronchial thermoplasty. It's a safe, effective procedure.
Melanie: And then, tell us why should they come to Palmdale Regional Medical Center for their care?
Dr. Ko: At this point, Palmdale Hospital is the only hospital that has bronchial thermoplasty in this area.
Melanie: Wow, that's absolutely fascinating. Thank you so much for being with us. You're listening to Palmdale Regional Radio. For more information, you can go to palmdaleregional.com. That's palmdaleregional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.