Impact of bronchial thermoplasty on exacerbation rates, quality of life, and healthcare utilization in severe asthma: a systematic review and meta-analysis of long-term outcomes.

BACKGROUND: Bronchial thermoplasty (BT) utilizes regulated radiofrequency radiation to diminish airway smooth muscle and enhance asthma management. This study aimed to assess the long-term effects of BT on asthma exacerbation rates, quality of life, healthcare utilization, lung function, and safety in adults with severe asthma. METHODS: We searched PubMed, Web of Science, and Scopus through August 2024. Seventeen studies (randomized controlled trials and observational cohorts) with ≥12-month follow-up were included. Outcomes assessed were exacerbations, quality of life, healthcare utilization, lung function, and adverse events. Data were synthesized using random-effects models. RESULTS: BT was consistently associated with reductions in severe exacerbations and emergency visits. Improvements in asthma-related quality of life were observed and remained evident during long-term follow-up. In contrast, changes in lung function were modest and often not significant. Reported adverse events were generally mild, occurred mainly in the early weeks after the procedure, and no additional long-term safety concerns were identified. CONCLUSIONS: BT provides sustained clinical benefits in carefully selected severe asthma patients, improving quality of life and reducing exacerbations without long-term safety concerns.