NICE interventional procedure guidance
Issued: January 2012

Bronchial thermoplasty for severe asthma

This is an extract from the guidance. The complete guidance is available at

1 Guidance

1.1 Evidence on the efficacy of bronchial thermoplasty for severe asthma shows some improvement in symptoms and quality of life, and reduced exacerbations and admission to hospital. Evidence on safety is adequate in the short and medium term. More evidence is required on the safety of the procedure in the long term. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.

1.2 Clinicians wishing to undertake bronchial thermoplasty for severe asthma should take the following actions.

  • Inform the clinical governance leads in their Trusts.

  • Ensure that patients understand the uncertainty about the procedure's efficacy and long-term safety, and the possibility of initial worsening of their symptoms, and provide them with clear written information. In addition, the use of NICE's information for patients (Understanding NICE guidance) is recommended.

  • Clinicians should submit details of all patients undergoing this procedure to the Difficult asthma registry.

  • Patient selection and treatment should be carried out by a respiratory team with special expertise in managing difficult and severe asthma.

1.3 NICE encourages further research into bronchial thermoplasty for severe asthma. Research outcomes should include objective measurements of lung function, symptom control, medication requirements and quality of life. Long-term safety and efficacy outcomes are particularly important. Collaboration between units to publish data on patients not involved in research studies would also be valuable.