View Abstract

A4861 - Literature in Severe Asthma: Bronchial Thermoplasty and Biological Agents
Author Block: T. Vandemoortele, G. Courteau-Godmaire; Pulmonology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Introduction: Severe asthma treatment and management is a constantly evolving field of studies. New therapeutic options have been developed and became available in the last decade. Bronchial thermoplasty and biological agents such as interleukin inhibitors (mepolizumab) and anti IgE monoclonal antibodies (omalizumab) are part of these new treatment modalities for severe asthma. Due to their high cost and limited availability, their use is restricted to carefully selected groups of patients. A bronchial thermoplasty treatment costs around 14,900 US$ per person-year. A treatment with omalizumab is approximately 22,700 US$/person-year and around 32,500US$/person-year for mepolizumab. Both of these interventional and medical treatments have been shown to decrease the number of exacerbations and symptoms in severe asthma patients. Faced with these effective but expensive options, different factors influence the choice of treatment. Available scientific literature is one of them. Is there a shift in literature toward a particular modality that could contribute to influence the choice of treatment? To explore this question, we looked at literature trends in terms of publications about bronchial thermoplasty and biological agents in severe asthma. Methods: We performed a focused literature review using PubMed. We extended our search from 2005 to 2017. We used the following keywords: asthma, severe asthma, bronchial thermoplasty, omalizumab, mepolizumab. We included every type of articles in our review. We compiled the total number of articles and the number of publications per year for each subjects. We presented the results in tables and graphs showing the trend of publications in time. In a qualitative perspective, we also looked at the funding source of the articles and their primary outcomes. Results: From 2005 to 2017, a total of 198 articles on bronchial thermoplasty, 165 on mepolizumab and 1065 on omalizumab have been published. There is a mean of 16,5 articles/year on bronchial thermoplasty, 13,75 articles/year on mepolizumab and 88,75 articles/year on omalizumab since 2005. There is an increase in publications per year on all 3 topics, especially since 2014-2015. Conclusion: The trend in the number of published literature favours biological agents although there is no direct comparison between these molecules and bronchial thermoplasty. This could possibly influence clinicians on their decision to choose one modality over another. A direct comparison in terms of efficacy, accessibility and cost-effectiveness would be interesting to guide and optimize the use of these expensive treatments.