31 August 2018

New “life changing” procedure can be offered to adults with severe asthma on NHS

Procedure could be an option for adults with severe asthma whose symptoms cannot be adequately controlled with drugs

NICE draft guidance published today (31 August) says a potentially life changing treatment for some adults with severe asthma is safe and effective enough for use on the NHS, depending on commissioning arrangements.

Bronchial thermoplasty for severe asthma takes place under sedation or general anaesthetic and short pulses of radiofrequency energy are applied to the airway wall.

Two further sessions of treatment with three weeks intervals take place to complete the procedure.

It reduces the smooth muscle mass lining the airways, decreasing their ability to constrict.

Having the procedure may decrease the severity and frequency of severe asthma attacks - thereby improving quality of life.

Professor Kevin Harris, programme director and clinical advisor for the Interventional Procedures Programme at NICE, said: “This is a procedure which is innovative and it does work.

“If you are frequently admitted to hospital with severe asthma which cannot be controlled with drugs, this is a procedure which people may wish to consider after discussions with their clinician.

“Asthma is a common disease and the vast majority of patients won’t require this treatment. But for people with severe asthma this procedure could be life changing.

“The committee was convinced it was safe enough and works well enough for use with standard arrangements in the NHS.”

Asthma is a long-term condition of the airways in the lungs that affects children, young people and adults. It causes inflammation and constriction of the smooth muscle in the airway walls (bronchoconstriction).

This is triggered by increased responsiveness of the airways to various allergic stimuli, leading to airflow obstruction.

Symptoms include recurring episodes of wheezing, breathlessness, chest-tightness and coughing.

Asthma is diagnosed and its severity assessed on the basis of symptoms and objective tests of lung function.

New data on this procedure allowed the independent committee to change their recommendation and to allow this procedure to be carried out under standard arrangements rather than special arrangements.

However it can only take place in specialist centres which have on-site access to intensive care.

There is no legal requirement to comply with the IPG recommendations we make, although it is considered best clinical practice for the NHS to do so. This means that if we have issued guidance recommending an interventional procedure, the decision to implement it is passed to NHS commissioners.

The consultation for this draft guidance closes on 28th September 2018.

Asthma is a common disease and the vast majority of patients won’t require this treatment. But for people with severe asthma this procedure could be life changing.

Professor Kevin Harris, programme director and clinical advisor for the Interventional Procedures Programme at NICE