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Editorials: POINT/COUNTERPOINT EDITORIALS |

Point: Efficacy of Bronchial Thermoplasty for Patients With Severe Asthma. Is There Sufficient Evidence? YesBronchial Thermoplasty for Asthma. Yes

Adrian Shifren, MD, FCCP; Alex Chen, MD; Mario Castro, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine.

Correspondence to: Mario Castro, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8052, St. Louis, MO 63110; e-mail: castrom@wustl.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts: Dr Castro has received university grant monies (each >$100,000) from the National Institutes of Health, Centers for Disease Control and Prevention, and ALA and pharmaceutical company grant monies (each >$100,000) from Asthmatx, which developed and markets the Alair Bronchial Thermoplasty System discussed in this article, Amgen, Cephalon, Centocor, GlaxoSmithKline, Genentech, Medimmune, Merck, Novartis, and Pfizer. Dr Castro has received consultancy fees ($10,001-$50,000) from Asthmatx, advisory board fees ($5,001-$10,000) from Genentech, and royalties from Elsevier. Dr Castro has been a consultant for Genentech and participated in speaking activities for AstraZeneca, Boeringer-Ingelheim, Genentech, Merck, and Pfizer. Drs Shifren and Chen report that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(3):573-575. doi:10.1378/chest.11-1410
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Extract

The overall burden of severe asthma on individuals and society is substantial because patients with severe asthma often experience disabling symptoms and account for a disproportionately high amount of asthma-care expenditures.1 Asthma is associated with persistent and progressive decline in lung function2 that is not modified by currently available therapeutic approaches, including inhaled bronchodilators and corticosteroids.3 The majority of patients with severe asthma require three to four medications and take long-term oral corticosteroids or frequent bursts.4 Despite these expensive therapies, patients with severe asthma are responsible for a disproportionately high share of asthma-associated morbidity and mortality5 and continue to experience repeated symptoms, including exacerbations that are potentially life threatening. In the Severe Asthma Research Program, we have demonstrated that almost one-half of these patients have sought emergency care in the past 12 months.6 Therefore, a substantial proportion of patients with severe asthma lack effective therapy to control their symptoms and to minimize impairment.

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