Heat treatment helps fight asthma

LOS ANGELES Mike and Jenny McLeland couldn't get through the day without their inhalers.


"At least once a month it was bad enough to go to the emergency room," said Mike. "I'd have asthma attacks two or three times a day. I was using my inhaler constantly."

"It doesn't matter how many asthma attacks I've had in my lifetime, I still start to feel kind of panicky," said Jenny. "What if I can't get to my inhaler in time? What if I can't get help in time?"

The couple was among the first to test a new treatment called bronchial thermoplasty that uses heat to alleviate asthma. Doctors send a catheter into the lungs and wires deliver radiofrequency energy to the constricted muscles around the windpipe.

"This is a permanent treatment where we actually alter the smooth muscle," said pulmonologist Dr. Mario Castro. "We decrease the muscle that's surrounding the windpipe, so it's a much more long-lasting treatment and effective treatment for these patients."

In an international clinical trial, patients showed an average of a 32-percent reduction in severe asthma symptoms. Jenny's cut her asthma meds by 50 percent and Mike doesn't need his at all.

"I am not using my inhalers," said Mike. "I'm off my steroid inhaler. I haven't used my Provental for the last three months."

Now, Mike and Jenny are enjoying something they never thought they could have -- an active lifestyle that gets better with every stride.

Doctors sedate patients for the procedure and it's done in sets of three that take 45 minutes each. The heat treatment is intended for patients with severe asthma that's not helped or controlled by medication.

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Every day in the United States, 40,000 people miss school or work because of asthma, according to the Asthma and Allergy Foundation of America. In addition, 5,000 people visit the emergency room and 11 people die every day due to asthma, which is caused by narrowing of the airways that transport air from the nose and mouth to the lungs. Alarmingly, death rates from asthma have increased more than 50 percent since 1980.


There is no cure for asthma. Treatments include avoiding allergy triggers and medications. Inhaled corticosteroids are prescribed to decrease inflammation of air passages, and bronchodilators to open up the windpipes. Both treatments are inhaled through a device and are intended to be taken on a daily basis. The American Academy of Allergy Asthma & Immunology says it is important to follow your physician's instruction regardless of whether or not you are experiencing symptoms.

A recent Food and Drug Administration analysis of four drugs used to treat asthma -- including Serevent, Advair, Foradil and Symbicort -- found the drugs carry an increased risk of asthma-related side effects, especially for children. All four drugs fall into a class called long-acting beta-antagonists, or LABAs. Researchers analyzed 110 trials involving the drugs and 60,954 patients. About 43,000 patients were involved in trials for the drug Serevent. There were 20 asthma-related deaths overall, and 16 of those patients were on Serevent.


For some asthma patients, symptoms are uncontrollable even with high doses of medications. Through a new treatment called bronchial thermoplasty, doctors are helping some of these patients by using heat to reduce the amount of muscle tissue in the lung's air passages. Reducing the amount of tissue helps inhibit narrowing of those passages. During the procedure, patients are sedated. In a recent study evaluating the treatment, patients underwent the procedure three times, three weeks apart.

After treatment, those treated with bronchial thermoplasty experienced 84 percent fewer visits to the emergency room for respiratory symptoms than untreated patients. "[Bronchodilators] help relax that smooth muscle, but they last for about four to six hours, whereas this is a permanent treatment where we actually alter the smooth muscle," Mario Castro, M.D., a pulmonologist at Washington University School of Medicine in St. Louis, Mo., said.

After each bronchial thermoplasty treatment, patients experienced a temporary, mild asthma attack. "We clearly want to discuss that with our patients ahead of time so they're aware of that risk, and then you have to balance that with the benefits from the procedure," Dr. Castro said.

After treatment, however, treated patients experienced fewer attacks than other participants. The device used in the procedure -- called Asthmatx -- has been submitted to the FDA for review, and experts expect a ruling sometime this fall.

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