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Bronchial Thermoplasty Including the Middle Lobe Bronchus Significantly Improves Lung Function and Quality of Life in Patients Suffering from Severe Asthma

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Abstract

Purpose

Bronchial Thermoplasty (BT) is indicated in patients suffering from severe and symptomatic bronchial asthma despite maximal medical therapy. However, treatment of the right middle lobe (RML) bronchus is currently not recommended. The aim of this study was to investigate the safety and efficacy of BT if the RML bronchus is included.

Methods

BT was performed in 17 consecutive patients, quality of life and pulmonary function were characterized before and 90 days after BT completion. Furthermore, we performed a clean-up bronchoscopy following every BT. This study was approved by the IRB of the University of Essen (No. 17-7356 BO) and registered as a retrospective observational study at the German Clinical Trials Registry (No. DRKS 00011550).

Results

The median baseline values of FEV1 and Asthma Questionnaire of Life Quality (AQLQ) were 1.33 l (0.91; 1.73) and 3.01 (2.76; 3.61), respectively, and significantly improved 90 days after treatment with FEV 1 at 1.75 l (p-value 0.002) and AQLQ 3.8 (p-value < 0.05). Also the amount of oral corticosteroid necessity decreased significantly. No severe adverse events occurred due to the procedure. Clean-up bronchoscopies—when performed—revealed significant fibrinous exudation after every BT procedure.

Conclusion

BT including the RML bronchus is feasible. Functionally limited patients with severe asthma could potentially profit. Due to the relevant fibrinous exudation, BT should be followed by clean-up bronchoscopy, not only after RML treatment.

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Authors and Affiliations

  1. Interventional Pneumology, Ruhrlandklinik-West German Lung Center, Essen, Germany

    Stephan Eisenmann, Faustina Funke, Filiz Oezkan & Kaid Darwiche

  2. Department of Pulmonary Medicine, University of Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle, Germany

    Stephan Eisenmann

  3. Martha-Maria Hospital Halle-Dölau, Halle, Germany

    Wolfgang Schütte

  4. Interventional Pulmonology, Ohio State University, Columbus, USA

    Shaheen Islam

Authors
  1. Stephan Eisenmann
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  2. Wolfgang Schütte
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  3. Faustina Funke
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  4. Filiz Oezkan
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  5. Shaheen Islam
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  6. Kaid Darwiche
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Contributions

Conception, design: SE, WS, FF, FO, SI, KD. Procedure performance: SE, WS. Data acquisition: SE, WS. Analysis and interpretation: SE, KD, FO, FF, WS, SI.

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Correspondence to Stephan Eisenmann.

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Eisenmann, S., Schütte, W., Funke, F. et al. Bronchial Thermoplasty Including the Middle Lobe Bronchus Significantly Improves Lung Function and Quality of Life in Patients Suffering from Severe Asthma. Lung 197, 493–499 (2019). https://doi.org/10.1007/s00408-019-00240-5

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  • DOI: https://doi.org/10.1007/s00408-019-00240-5

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