St. Andrew’s offers innovative asthma therapy

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Once we decrease the smooth muscle to 20 per cent, there is less narrowing of the airways and less likelihood of a severe attack

People with chronic asthma will benefit from an innovative new treatment available at St Andrew’s War Memorial Hospital which has been shown in clinical trials to substantially reduce severe asthma attacks and hospital emergency visits.

St Andrew’s is the first hospital in Queensland to offer the treatment, known as bronchial thermoplasty. It is a minimally invasive procedure, performed under light anaesthesia, which delivers controlled radiofrequency (RF) energy to a patient’s lung airways to gently heat and shrink the smooth muscle in the airway wall.

St Andrew’s thoracic specialist, Dr Samuel Kim, said people with severe asthma have abnormally thick smooth muscle circling their airways and this smooth muscle contracts during an asthma attack, squeezing the airways and constricting breathing.

“Radiofrequency energy has been used for medical applications for many years,” Dr Kim said. “With bronchial thermoplasty it is the underlying smooth muscle, and not the airway lining itself, that is sensitive to the low frequency radio waves – so this is a gentle, non-surgical outpatient procedure.

“Once we decrease the smooth muscle to about 20 per cent, there is less narrowing of the airways during an asthma attack and less likelihood of a severe attack.

“The procedure is indicated for adults with moderate to severe asthma, who are on heavy doses of steroids and preventers, who have persistent asthma symptoms, and who find they have to go to hospital emergency several times a year because of difficulty in breathing. Asthma severely affects these patients’ quality of life.”

Deputy Chief Medical Officer for UnitingCare Health and Director of Medical Services at St Andrew’s War Memorial Hospital, Dr Christian Rowan, said: “St Andrew’s is at the forefront of clinical practice and committed to providing first-class treatment and results. Bronchial thermoplasty is another example of how we deliver innovative and technologically-advanced healthcare solutions.”

In international Asthma Intervention Research 2 (AIR2) clinical trials, 79 per cent of severe asthma patients who received bronchial thermoplasty reported significant improvements in their quality of life following treatment.

The latest trial data published in September 2013 in The Journal of Allergy and Clinical Immunology in the US showed that five years after treatment, patients had an average 48 per cent decrease in severe asthma attacks and an average 88 per cent decrease in visits to hospital emergency rooms.

Dr Kim has participated in dedicated bronchial thermoplasty training with Associate Professor Pyng Lee from the National University of Singapore School of Medicine, and Professor of Respiratory Medicine at Perth’s Sir Charles Gairdner Hospital, Dr Martin Phillips, who was involved in the AIR2 clinical trials.

Bronchial thermoplasty involves three separate treatments several weeks apart – one for each lung’s lower lobe, and the third for the upper lobes of both lungs. The RF energy is delivered via an expanding catheter inserted into a standard flexible bronchoscope, which is introduced into the lung via the patient’s nose or mouth. Each treatment usually takes about an hour and is performed in the St Andrew’s Endoscopy Centre.

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