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Non-drug asthma treatment may change lives

July 4, 2010 12:00:00 AM PDT
The FDA recently approved the first non-drug asthma treatment. It could change the lives of the many Americans who suffer from the disease.It's not the saws or the hammers that makes Jeff Craddock's job dangerous.

"We have either the saw dust or the dry wall dust, or we have the insulation back here," said Jeff, who suffers from asthma.

He feared he'd have to sell his business to save his life.

"I would have to use a rescue inhaler at a minimum, between four, five times a day," said Jeff.

When medication failed, he tried a new approach: bronchial thermoplasty.

With normal breathing, the airways of the lungs are fully open. People with severe asthma have more muscle surrounding their airways. This excess muscle combined with inflammation makes the walls even thicker. During bronchial thermoplasty, a small tube is inserted through the mouth or nose into the lungs.

A flexible catheter delivers radiofrequency energy to the muscles around the windpipe.

"This brings the wires in contact with the lining of the breathing tube," explained Dr. David Duhamel, a pulmonologist.

The heat prevents the muscles from contracting and narrowing during an attack.

"It's about the temperature of a warm cup of coffee. It's not burning. It's not sparking. It's not ablating or anything," described Duhamel.

A new study shows a 32-percent reduction in asthma attacks, 84-percent drop in emergency room visits, 73-percent reduction in hospital stays and 66-percent drop in lost time from work or school.

The new therapy allowed Jeff to do chores that used to take his breath away.

"Breathing in, it doesn't affect me anymore. I'm not at home just trying to exist. I'm actually working," said Jeff.

Jeff is working hard and breathing easier for the first time in a long time.

Doctors stress that this device does not cure asthma; it only improves the patient's quality of life and helps them breathe easier. There's little risk since there is no incision, but patients may suffer from worse asthma symptoms in the days immediately following the procedure.

Asthma:

Asthma is a chronic lung disease that inflames and narrows the airways. It causes recurring periods of wheezing, chest tightness, shortness of breath and coughing. The inflammation can be trigged by a number of internal and external factors, but the exact cause is not known. The airways then swell and fill with mucus, making it difficult to breathe. Because asthma causes resistance, or obstruction, to exhaled air, it is called an obstructive lung disease.

Asthma is one of the most common and most costly diseases in the world, and presently, it has no cure. More than 20 million Americans have asthma, and managing asthma costs as much as $18 billion each year. In the U.S. each year, asthma attacks result in almost 10 million outpatient visits and 2 million emergency room visits. It also accounts for 500,000 hospitalizations and 4,000 deaths each year.

Treatments:

Treatments for asthma can be divided into long-term control and quick-relief medications. There are two major groups of medications used in controlling asthma: anti-inflammatories and bronchodilators. Anti-inflammatories reduce the number of inflammatory cells in the airways and prevent blood vessels from leaking fluid into the airway tissues. Bronchodilators work by increasing the diameter of the air passages and easing the flow of gases to and from the lungs. Regular follow-up visits (at least every six months) are important to maintain asthma control and to reassess medication requirements.

Bronchial thermoplasty:

Bronchial thermoplasty is the first device-based asthma treatment approved by the FDA. It's performed through the working channel of a standard flexible bronchoscope that is passed through a patient's nose or mouth, into the lungs. The tip of the small catheter is expanded to contract the walls of targeted airways. The thermal energy is then delivered to the airway walls to reduce the presence of excess airway smooth muscle that narrows the airways in patients with asthma. By decreasing the ability of the airways to constrict, this new treatment has been shown to help patients with severe asthma gain substantially better control over their disease.

According to a recent study in the American Journal of Respiratory and Critical Care Medicine, the patients treated with bronchial thermoplasty saw their quality of life improve. They saw a 32 percent drop in asthma attacks, an 84 percent reduction in emergency room visits for respiratory symptoms, a 73 percent drop in hospitalizations for respiratory symptoms and a 66 percent reduction in days lost from work or school or other daily activities due to asthma.


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