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NICE backs 'life changing' asthma procedure for wider NHS use

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An “innovative” procedure that has the power to the change the lives of people with severe asthma has taken a major step towards being approved for routine use on the NHS.

Draft guidance published today by the National Institute for Health and Care Excellence (NICE) said that bronchial thermoplasty was a safe and effective treatment of the respiratory condition in adults.

“Every asthma attack is life-threatening”

Joe Farrington-Douglas

Previously, the procedure was only permitted under strict “special arrangements”, but new evidence allowed NICE to relax its recommendation to enable clinicians to offer it as a “standard” option to patients.

Bronchial thermoplasty takes place under sedation or general anaesthetic and short pulses of radiofrequency energy are applied to the airway wall over a series of sessions.

The treatment reduces the smooth muscle mass lining the airways, decreasing their ability to constrict, and could lessen the severity and frequency of asthma attacks in patients.

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,” he said.

“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,” he noted.

“This is a procedure which is innovative and it does work”

Kevin Harris

Professor Harris added that the NICE committee that considered the treatment “was convinced it was safe enough and works well enough for use with standard arrangements in the NHS”.

However, there is no legal requirement to comply with the recommendations and the decision to fund treatment is down to local NHS commissioners.

The charity Asthma UK welcomed the publication of the draft guidance. Joe Farrington-Douglas, head of policy and external affairs at the charity, said: “Making this treatment available to more people could offer much needed hope to thousands of people in the UK who have severe asthma.”

He added: “This debilitating form of asthma is resistant to regular treatments, meaning many have to cope with terrifying asthma symptoms, such as gasping for breath, as well repeated trips to A&E. Every asthma attack is life-threatening.”

Mr Farrington-Douglas said the charity was now calling on the NHS to recognise the importance of severe asthma treatments and ensure local health bodies fund them.

Joe Farrington-Douglas

Joe Farrington-Douglas

Joe Farrington-Douglas

He added that there was also a need for more research into the long-term side effects of all treatments for severe asthma.

Asthma UK estimates there to be around 200,000 adults and children in the UK with severe asthma. However, Mr Farrington-Douglas said it was difficult to diagnose and therefore many patients ”slip through the net and don’t get the help they need”.

Bronchial thermoplasty can only take place in specialist centres with on-site intensive care facilities. 

The consultation on the draft NICE guidance closes on 28 September 2018.

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