Towards optimal patient selection for bronchial thermoplasty treatment in severe asthma: results from the TASMA randomized trial
New therapies (English)BACKGROUND Bronchial Thermoplasty (BT) is a treatment for severe uncontrolled asthma patients. Although studies have shown clinical improvement after BT, not all patients respond equally well. Identifying optimal candidates for BT treatment is needed.
AIM To identify patient characteristic differences between BT responders and non-responders.
METHODS Patients from the multicenter TASMA trial were included in this analysis. Before BT, a set of clinical, functional, inflammatory and airway biopsy data were collected (Table 1). A positive BT response was defined as a minimal clinically important change of >0.5 on asthma control questionnaire (ACQ) score, 6 months after BT.
RESULTS 30 patients were analyzed. ACQ improved from 2.66 (±0.68) to 2.09 (±1.07) (p<0.01). Responders (n=15) improved from ACQ 2.66 (±0.63) to 1.24 (±0.67) (p<0.0001) while in non-responders (n=15) ACQ remained stable (ACQ pre-BT 2.67 (±0.75) and post-BT 2.95 (±0.61)). Significantly higher levels of immune globulin (Ig) E and blood eosinophils were found in BT responders compared to non-responders (Table 1). All other characteristics (Table 1), including ASM mass, were not significantly different between groups.
CONCLUSION IgE and blood eosinophils before BT were higher in BT responders compared to non-responders and might therefore contribute in optimizing patient selection for BT.