NICE consults on asthma drug reducing procedure
pharmafile | July 26, 2011 | News story | Sales and Marketing | NICE, asthma
NICE has launched a consultation in the UK on a new medical procedure which, if it proves safe and effective, may be a threat to established asthma drugs.
Bronchial thermoplasty is the first non-drug asthma treatment the health watchdog has looked at, and NICE believes it could cut severe asthma sufferers’ dependence on pharma products.
“The evidence suggests that bronchial thermoplasty can offer significant improvements in quality of life by making breathing easier and reducing the need for medicines and inhalers,” said Professor Bruce Campbell, chair of the independent committee that develops NICE’s interventional procedures guidance.
But he warned: “Thermoplasty may cause symptoms to worsen to start with, which can be very serious for people with severe asthma.”
There is also no evidence yet to indicate whether it improves lung function beyond the trial period.
NICE’s draft guidance advises doctors to make potential patients aware of the lack of knowledge about long-term effects and the potential risks before obtaining consent.
Respiratory teams are then required to inform their clinical governance leads (usually a hospital’s medical director) and audit clinical outcomes in a bid to establish more data.
Bronchial thermoplasty works by heating the airways in the lungs, inserting a special catheter through nose or mouth into the tubes (bronchi) which carry air to the lungs.
Patients are under moderate sedation, and the catheter delivers radiofrequency heat which destroys part of the muscle lining of the airways – the muscle that contracts to cause asthma attacks and hamper breathing.
Treatment is usually carried out in three sessions, at least three weeks apart, with the success of the first stage assessed by bronchoscopy before the process proceeds.
The consultation ends on 19 August, with NICE due to publish in November final guidance, based on safety and efficacy, that will outline what healthcare professionals should do if they are considering the surgery as a treatment option.
NICE will also be publishing information designed for patients to explain the consent process and outline what the procedure involves and what safety and efficacy evidence NICE has looked at.
Current asthma treatments include Merck’s Singulair (montelukast) and AstraZeneca’s Pulmicort Respules (budesonide inhalation suspension).
There is ongoing research in asthma, but not all is successful: in May, Pfizer returned the rights to a phase I asthma candidate, inhaled syk inhibitor R343, to Rigel pharmaceuticals.
Adam Hill
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