New Treatment for Patients With Severe Asthma

SALT LAKE CITY — LDS Hospital is the first hospital in Utah to offer new hope to patients with severe asthma. The treatment, called bronchial thermoplasty, uses heat to treat the airways of the lung, reducing muscle spasms and allowing patients to breathe freely. It is designed for adults who struggle to control their asthma with medication.

 

“This is very exciting technology for patients who have severe or poorly controlled asthma,” says James Pearl, MD, an interventional pulmonologist at LDS Hospital who began treating patients with bronchial thermoplasty a year ago. “Until now, medication has been pretty much our only tool for fighting severe asthma. But some people don’t respond well to the drugs we use. For those people, this technology may reduce life-threatening episodes of severe asthma.”

 

In fact, studies conducted one year after bronchial thermoplasty treatment have shown: 

The improvements in asthma attacks have continued for two years after treatment, say researchers. Patients were followed for five years and longer-term results are expected next year.

 

Trent Aiken knows full-well the perils of asthma and the benefits of bronchial thermoplasty. Every night for the past 42 years — since he was six months old — he’s had to wake up at 1 a.m. to take medication or breathing treatments that last 30-60 minutes. After one bronchial thermoplasty treatment, that ended for Trent.

 

Trent never played sports as a kid, has had two visits to the ICU for severe asthma attacks, and has lived his life battling asthma so severe that he once made the journey to National Jewish Health’s hospital in Denver to learn how to better take care of his asthma. And for the first time he feels like he’s never felt before.

 

“I can breathe better, I’m not up at night, and this actually treats the disease, not just the symptoms of asthma,” says Trent. “After the second of three treatments I felt like I was on my most heavy doses of medication, but I wasn’t on them at all”

Approximately 180,000 adults and 60,000 children have asthma in Utah. The disease results in nearly 1,500 hospitalizations and more than 7,000 trips to the emergency room each year, according to the Utah Department of Health. It also results in nearly 3,500 deaths a year nationally. Symptoms can be worse in the winter due to cold temperatures and poor air quality along the Wasatch Front.

 

Studies on the effectiveness of bronchial thermoplasty have been published in the American Journal of Respiratory and Critical Care Medicine and other medical journals. Two years ago, the U.S. Food and Drug Administration approved the Alair Bronchial Thermoplasty System for use in patients who are 18 years and older and who suffer from severe, persistent asthma that is not well controlled with inhaled corticosteroids and long acting beta agonists, the current standard treatments.  LDS Hospital is the first hospital in Utah to offer the therapy.

 

Bronchial thermoplasty delivers thermal energy to the airway wall in a precisely controlled manner to reduce excess muscle. Reducing the muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks.

 

The procedure is minimally invasive and begins when a physician inserts a small bronchoscope through the patient's mouth or nose and into the lungs. The tip of the catheter is expanded to contact the walls of the targeted airways. Controlled bursts of heat are then delivered. The procedure is performed under moderate sedation or light anesthesia, and the patient typically goes home the same day.

 

Treatment includes three outpatient visits, scheduled approximately three weeks apart. After all three procedures are performed, treatment is complete.

 

“It’s hard for people to understand what asthma’s like, but here’s one way to experience it,” says Trent. “Take in a deep breath and hold it; then without letting any air out, take another deep breath and hold that. Physically your brain wants to breathe in deeper but what your body needs is to exhale.”

 

Patients who are 18 or over and who struggle with asthma that is not well controlled with medication may be candidates for treatment. For more information, patients should contact their allergist or primary care physician to be referred to Dr. Pearl to see if the treatment is appropriate for them.’

 

Medicare is covering bronchial therapy for patients who meet certain criteria and are treated in a hospital. But because the treatment is so new, most insurers have not yet approved a reimbursement policy. Some insurers nationally have covered the treatment on a case-by-case basis.