Effectiveness and Safety of Bronchial Thermoplasty in the Treatment of Severe Asthma with Smoking History: A Single-Center Experience.
INTRODUCTION
Bronchial thermoplasty (BT) improves asthma-related quality of life and decreases the number of asthma exacerbations. However, the effectiveness of BT in the treatment of severe asthma with smoking history is unclear because previous studies have excluded patients with smoking history of more than 10 pack-years.


OBJECTIVE
The aim of the study was to clarify the effectiveness and safety of BT for severe asthma with smoking history.


METHODS
We retrospectively reviewed patients who received BT and compared its effectiveness and safety with and without smoking history.


RESULTS
Seven patients were assigned to the smoking group and 9 to the nonsmoking group. Before BT, despite Global Initiative for Asthma step 4 or 5 treatment including oral corticosteroids (OCS) or monoclonal antibody drugs, most patients in both groups had asthma-related symptoms every day (85.7 vs. 77.8%; p = 0.475) and frequent asthma exacerbations. After BT, in the smoking group, 3 patients could discontinue or reduce OCS and all 3 patients treated with monoclonal antibody drugs could discontinue them. In the smoking group, 6 patients (85.7%) experienced a reduction in the rate of symptoms, of which 3 patients (42.9%) had a disappearance of symptoms, similar to the nonsmoking group. BT was effective in 5 patients (83.3%) in the smoking group and 6 patients (75.0%) in the nonsmoking group. There were no severe complications.


CONCLUSIONS
BT was found to be effective and safe for treatment of severe asthma with smoking history. Our results suggest that BT may be a therapeutic option for asthma-chronic obstructive pulmonary disease overlap.
['Otoshi|Ryota|R|', 'Baba|Tomohisa|T|', 'Aiko|Naoto|N|', 'Tabata|Erina|E|', 'Sadoyama|Shinko|S|', 'Nakagawa|Hiroaki|H|', 'Sekine|Akimasa|A|', 'Komatsu|Shigeru|S|', 'Hagiwara|Eri|E|', 'Ogura|Takashi|T|']
D000328:Adult D001249:Asthma D000074060:Bronchial Thermoplasty D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D012907:Smoking
Bronchial thermoplasty Asthma Smoking history Asthma and chronic obstructive pulmonary disease overlap Chronic obstructive pulmonary disease