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NICE guidance advises caution on asthma heat treatment

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Clinicians should take special care when deciding whether to use new non-drug treatment for severe asthma because more research is needed into the practice, latest guidance state.

The guidelines from the National Institute for Health and Clinical Excellence, which were published yesterday, said that “bronchial thermoplasty” – which involves heating the tissue of the lung airways – could help some patients by cutting reliance on inhalers.

Bronchial thermoplasty involves inserting a catheter into a patient’s nose or mouth and pumping radiofrequency heat into the airways. This destroys the part of the muscle lining which contracts during an asthma attack.

However, although some patients report a cut in asthma attacks, others experienced a worsening of symptoms in the short term. There is also no evidence available about whether the treatment works over the long-term, or any damage to the lungs which may be caused.

NICE advised respiratory teams to explain the uncertainties around the treatment to patients, keep clinical governance leads informed, and audit clinical outcomes so more can be learnt about long-term effects.

Professor Bruce Campbell, chair of NICE’s independent committee developing guidance on interventional procedures, said: “The evidence suggests that bronchial thermoplasty can offer significant improvements in quality of life… however more evidence is needed about its benefits in the long term.”

Decisions on the cost of the procedure will be made at a local level.

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