Recommendations for the use of bronchial thermoplasty in the management of severe asthma

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dc.contributor.authorDheda, Keertanen_ZA
dc.contributor.authorKoegelenberg, Coenraad F. N.en_ZA
dc.contributor.authorEsmail, Aliasgaren_ZA
dc.contributor.authorIrusen, Elvisen_ZA
dc.contributor.authorWechsler, Michaelen_ZA
dc.contributor.authorNiven, Rob M.en_ZA
dc.contributor.authorBateman, Eric D.en_ZA
dc.contributor.authorChung, Kian Fanen_ZA
dc.date.accessioned2016-08-02T06:49:20Z
dc.date.available2016-08-02T06:49:20Z
dc.date.issued2015
dc.descriptionCITATION: Dheda, K., et al. 2015. Recommendations for the use of bronchial thermoplasty in the management of severe asthma. South African Medical Journal, 105(9):726-732, doi:10.7196/SAMJnew.8207.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractThere are approximately 3 million asthma suffers in South Africa, and the national death rate is ranked as one of the highest in the world. Approximately 5% have severe asthma (uncontrolled despite being adherent on maximal and optimised therapy). Such uncontrolled asthma is associated with high healthcare expenditure and may require treatment with anti-IgE and/or systemic corticosteroids, in addition to inhaler therapy and oral agents. These treatments may be costly, and those such as oral corticosteroids may have potential serious adverse events. There is therefore a need for more effective, affordable and safe therapies for asthma. A new modality of treatment, bronchial thermoplasty (BT), has recently been developed and approved for the treatment of severe asthma. BT involves delivering radio frequency-generated thermal energy to the airways, with the goal of reducing airway-specific smooth-muscle mass. Several clinical studies have confirmed that BT is effective and safe, that it improves control and quality of life in patients whose asthma remains severe despite optimal medical therapy, and that the beneficial effects are sustained for at least 5 years. We provide recommendations for the management of severe asthma, with an emphasis on the role of BT, and endorse the use of BT in patients with severe persistent asthma who remain uncontrolled despite optimal medical therapy as outlined in steps 4 and 5 of the British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN), UK National Institute of Clinical Excellence (NICE) and Global Initiative for Asthma (GINA) guidelines. We outline the context in which BT should be used, how it works and associated potential adverse events and contraindications, and also review unanswered questions and controversies.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/9964
dc.description.versionPublisher's version
dc.format.extent7 pagesen_ZA
dc.identifier.citationDheda, K., et al. 2015. Recommendations for the use of bronchial thermoplasty in the management of severe asthma. South African Medical Journal, 105(9):726-732, doi:10.7196/SAMJnew.8207
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJnew.8207
dc.identifier.urihttp://hdl.handle.net/10019.1/99297
dc.language.isoen_ZAen_ZA
dc.publisherHealth & Medical Publishing Groupen_ZA
dc.rights.holderHealth & Medical Publishing Groupen_ZA
dc.subjectAsthma -- Treatmenten_ZA
dc.subjectBronchial thermoplastyen_ZA
dc.subjectMedical indicationsen_ZA
dc.titleRecommendations for the use of bronchial thermoplasty in the management of severe asthmaen_ZA
dc.typeArticleen_ZA
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