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.

1.
Castro
M
,
Rubin
AS
,
Laviolette
M
,
Fiterman
J
,
De Andrade Lima
M
,
Shah
PL
, et al.
Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial
.
Am J Respir Crit Care Med
.
2010 Jan
;
181
(
2
):
116
24
.
2.
Chupp
G
,
Laviolette
M
,
Cohn
L
,
McEvoy
C
,
Bansal
S
,
Shifren
A
, et al.
Long-term outcomes of bronchial thermoplasty in subjects with severe asthma: a comparison of 3-year follow-up results from two prospective multicentre studies
.
Eur Respir J
.
2017 Aug 31
;
50
(
2
)
50
.
3.
Global Initiative for Asthma
.
Global strategy for Asthma Management and Prevention
.
2017
. Available from: http://ginasthma.org/2017-gina-report-strategy-for-asthma-management-and-prevention/.
4.
Gibson
PG
,
McDonald
VM
.
Asthma-COPD overlap 2015: now we are six
.
Thorax
.
2015 Jul
;
70
(
7
):
683
91
.
5.
Wurst
KE
,
Kelly-Reif
K
,
Bushnell
GA
,
Pascoe
S
,
Barnes
N
.
Understanding asthma-chronic obstructive pulmonary disease overlap syndrome
.
Respir Med
.
2016 Jan
;
110
:
1
11
.
6.
Kondo
M
,
Tamaoki
J
.
Therapeutic approaches of asthma and COPD overlap
.
Allergol Int
.
2018 Apr
;
67
(
2
):
187
90
.
7.
Ishiura
Y
,
Fujimura
M
,
Ohkura
N
,
Hara
J
,
Kasahara
K
,
Ishii
N
, et al.
Effect of triple therapy in patients with asthma-COPD overlap
.
Int J Clin Pharmacol Ther
.
2019 Aug
;
57
(
8
):
384
92
.
8.
Chakir
J
,
Haj-Salem
I
,
Gras
D
,
Joubert
P
,
Beaudoin
ÈL
,
Biardel
S
, et al.
Effects of bronchial thermoplasty on airway smooth muscle and collagen deposition in asthma
.
Ann Am Thorac Soc
.
2015 Nov
;
12
(
11
):
1612
8
.
9.
Braunstahl
GJ
,
Chen
CW
,
Maykut
R
,
Georgiou
P
,
Peachey
G
,
Bruce
J
.
The eXpeRience registry: the ‘real-world’ effectiveness of omalizumab in allergic asthma
.
Respir Med
.
2013 Aug
;
107
(
8
):
1141
51
.
10.
Kanda
Y
.
Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics
.
Bone Marrow Transplant
.
2013 Mar
;
48
(
3
):
452
8
.
11.
Japanese Respiratory Society (JRS). The JRS Guidelines for the Management of ACO 2018. Medical Review, Tokyo 2018 (in Japanese)
.
12.
Gibson
PG
,
Simpson
JL
.
The overlap syndrome of asthma and COPD: what are its features and how important is it?
Thorax
.
2009 Aug
;
64
(
8
):
728
35
.
13.
Brutsche
MH
,
Downs
SH
,
Schindler
C
,
Gerbase
MW
,
Schwartz
J
,
Frey
M
, et al.
Bronchial hyperresponsiveness and the development of asthma and COPD in asymptomatic individuals: SAPALDIA cohort study
.
Thorax
.
2006 Aug
;
61
(
8
):
671
7
.
14.
Fabbri
LM
,
Romagnoli
M
,
Corbetta
L
,
Casoni
G
,
Busljetic
K
,
Turato
G
, et al.
Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease
.
Am J Respir Crit Care Med
.
2003 Feb
;
167
(
3
):
418
24
.
15.
Donohue
JF
,
van Noord
JA
,
Bateman
ED
,
Langley
SJ
,
Lee
A
,
Witek
TJ
 Jr
, et al.
A 6-month, placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol
.
Chest
.
2002 Jul
;
122
(
1
):
47
55
.
16.
Slebos
DJ
,
Shah
PL
,
Herth
FJ
,
Pison
C
,
Schumann
C
,
Hübner
RH
, et al.
Safety and adverse events after targeted lung denervation for symptomatic moderate to severe COPD (AIRFLOW): a multicenter randomized controlled trial
.
Am J Respir Crit Care Med
.
2019 Dec 15
;
200
(
12
):
1477
86
.
17.
Valipour
A
,
Asadi
S
,
Pison
C
,
Jondot
M
,
Kessler
R
,
Benneddif
K
, et al.
Long-term safety of bilateral targeted lung denervation in patients with COPD
.
Int J Chron Obstruct Pulmon Dis
.
2018 Jul
;
13
:
2163
72
.
18.
Pretolani
M
,
Bergqvist
A
,
Thabut
G
,
Dombret
MC
,
Knapp
D
,
Hamidi
F
, et al.
Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: clinical and histopathologic correlations
.
J Allergy Clin Immunol
.
2017 Apr
;
139
(
4
):
1176
85
.
19.
Ichikawa
T
,
Panariti
A
,
Audusseau
S
,
Mogas
AK
,
Olivenstein
R
,
Chakir
J
, et al.
Effect of bronchial thermoplasty on structural changes and inflammatory mediators in the airways of subjects with severe asthma
.
Respir Med
.
2019 Apr
;
150
:
165
72
.
20.
Marc Malovrh
M
,
Rozman
A
,
Škrgat
S
,
Šilar
M
,
Šelb
J
,
Fležar
M
, et al.
Bronchial thermoplasty induces immunomodulation with a significant increase in pulmonary CD4+25+ regulatory T cells
.
Ann Allergy Asthma Immunol
.
2017 Sep
;
119
(
3
):
289
90
.
21.
Yamamura
K
,
Hara
J
,
Ohkura
N
,
Abo
M
,
Sone
T
,
Kimura
H
, et al.
Increased cough receptor sensitivity to capsaicin predicts a positive bronchial thermoplasty response: a single-center retrospective study
.
J Bronchology Interv Pulmonol
.
2019 Apr
;
26
(
2
):
137
41
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.