Bronchial thermoplasty for severe asthma

This is a new guideline on bronchial thermoplasty from NICE on bronchial thermoplasty for severe asthma. NICE advise that it can be used.

This procedure reduces the smooth muscle mass lining the airways, making them less able to constrict. It is done under sedation or under GA. A catheter is inserted into the lungs and radiofrequency energy pulses are delivered to the airways. Normally three procedures are needed, three weeks apart.

It should only be done in specialist centres with access to ITU.

I've had a look through the evidence and it is a bit hard to be clear (with my non-expert stats understanding) on how effective this procedure is. Unusually there is no clear commentary from the guideline committee. It certainly seems to improve quality of life compared to control or sham treatment, but there is variable evidence on whether it improves asthma control.

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