June 7, 2012

New therapy helps asthma patients breathe more easily

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Otis Rickman, D.O., uses the Alair Bronchial Thermoplasty System to help treat patients with severe asthma. (photo by Joe Howell)

New therapy helps asthma patients breathe more easily

Hannah Andrews, 23, who has suffered from severe asthma since she was a child, is breathing easier now thanks to a new procedure offered at Vanderbilt known as bronchial thermoplasty.

Vanderbilt is the first medical center in Nashville to offer the Alair Bronchial Thermoplasty System, which was recently approved by the U.S. Food and Drug Administration (FDA).

Andrews spent a significant portion of her day managing her asthma, taking 15 different medications including a monthly IV treatment that costs $30,000 a year.

She underwent the first of three bronchial thermoplasty procedures on May 24 and is already feeling some relief.

“Asthma affects my life in every way. I can’t walk too much, and I miss school because of it,” she said.

Otis Rickman, D.O., director of bronchoscopy and assistant professor of Medicine and Thoracic Surgery, performed the one-hour procedure using a standard flexible bronchoscope that is introduced through the patient’s nose or mouth, and into their lungs. The tip of the small-diameter Alair catheter is expanded to contact the walls of targeted airways.

Controlled 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.

“It’s like putting the smooth muscle in a microwave,” Rickman said. “Radiofrequency energy destroys smooth muscle, which is what causes the constriction.”

The minimally invasive procedure is done under moderate sedation, and the patient returns home the same day. Andrews will return to Vanderbilt for two more treatments to complete the series.

“This new therapy is an adjunct to other therapy and not a cure,” Rickman said. “It is designed for patients with category 5 or 6 asthma who are on multiple inhalers, have several doctor office visits and a high level of health care utilization. It has shown an 80 percent reduction in ER visits and a 60 percent reduction in office visits.

“What I hope is we may be able to get people off steroids or other IV medications.”

Millions of patients with asthma struggle to keep their disease under control. Asthma accounts for 2 million emergency room visits in the United States each year. Each day, roughly 40,000 unscheduled physician office visits, 5,000 emergency room visits, and 1,000 hospitalizations occur due to asthma.