Evidence map›Paper›PMID 41907855›Full record

ArticleThe journal of allergy and clinical immunology. Global2026

Bronchial thermoplasty for severe asthma: Systematic review and meta-analysis of benefits and harms.

Daniel G Rayner, Alexandro W L Chu, Gerard Cox, Leonardo Ologundudu, Melanie M Wong, Nazmul Islam, Peter Bonta, Pallav L Shah, Dirk-Jan Slebos, Jouke Annema and 25 more

Abstract read
In one paragraph

Article in The journal of allergy and clinical immunology. Global, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Daniel G RaynerEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Alexandro W L ChuEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Gerard CoxDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Leonardo OlogunduduEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Melanie M WongEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Nazmul IslamEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Peter BontaDepartment of Pulmonology, University of Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Pallav L ShahNational Heart & Lung Institute, Imperial College, London, United Kingdom.
Dirk-Jan SlebosDepartment of Pulmonary Diseases, University of Groningen, Groningen, The Netherlands.
Jouke AnnemaAmsterdam University Medical Center, Amsterdam, The Netherlands.
Xiajing ChuEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Bradley ChippsCapital Allergy & Respiratory Disease Center, Sacramento, Calif.
John OppenheimerDepartment of Internal Medicine, University of Medicine and Dentistry of New Jersey-Rutgers New Jersey Medical School, Newark, NJ.
Elliot IsraelBrigham and Women's Hospital, Harvard Medical School, Boston, Mass.
Katherine Rivera-SpoljaricDivision of Allergy, Immunology, and Pulmonary Medicine, Washington University School of Medicine in St Louis, St Louis, Mo.
Tamara T PerryDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Ark.
Sharmilee M NyenhuisSection of Allergy, Immunology and Pediatric Pulmonology, Department of Pediatrics, University of Chicago, Chicago, Ill.
Flavia HoyteDepartment of Medicine, National Jewish Health, Denver, Colo.
Kaharu SuminoDepartment of Medicine, Washington University School of Medicine, St Louis, Mo.
Paul M O'ByrneDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Lindsay E ShadeAtrium Health Wake Forest Baptist School of Medicine, Winston-Salem, NC.
Gordon H GuyattDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Valerie G PressDepartment of Medicine, University of Chicago, Chicago, Ill.
Susana RangelLos Angeles General Medical Center, Los Angeles, Calif.
Ellen McCabeHunter-Bellevue School of Nursing, Hunter College, New York, NY.
Angel MelendezPatient and Caregiver Partner.
Dia Sue-Wah-SingPatient and Caregiver Partner.
Hilarry OrrPatient and Caregiver Partner.
Donna D GardnerAllergy & Asthma Network, Fairfax, Va.
Tonya WindersGlobal Allergy & Airways Patient Platform, Vienna, Austria.
Kathyrn PrzywaraAsthma and Allergy Foundation of America, Arlington, Va.
Matthew A RankDepartment of Internal Medicine, Mayo Clinic, Phoenix, Ariz.
Giselle MosnaimDepartment of Medicine, Endeavor Health, Evanston, Ill.
Leonard B BacharierDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Derek K ChuEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The efficacy and safety of bronchial thermoplasty (BT) for severe asthma remains unclear. Objective: We systematically synthesized the efficacy and safety of BT in patients with severe asthma. Methods: As part of the upcoming American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force on Practice Parameters severe asthma guidelines, we searched the Medline, Embase, and Central databases to July 29, 2025, for randomized trials comparing BT to control for asthma. Paired reviewers independently screened records and extracted data. Random-effects meta-analyses addressed asthma control (Asthma Control Questionnaire 6 [scale, 0-6; lower better]), asthma-related quality of life (Asthma Quality of Life Questionnaire [range, 1-7; higher better]), severe asthma exacerbations, and harms, stratified by procedural, postprocedural, and overall. The GRADE approach informed certainty-of-evidence ratings (PROSPERO: CRD42023408565). Results: Six trials randomized 573 adults. Procedurally, BT likely increases severe exacerbations (incidence rate ratio [IRR] 2.95; 95% CI, 1.20-7.25; risk difference [RD] 0.08 more events per patient-year; moderate certainty) and serious respiratory adverse events (IRR 5.98; 95% CI, 1.07-33.29; RD 0.18 more events per patient-year; moderate certainty). Postprocedurally, BT may reduce severe exacerbations (IRR 0.67; 95% CI, 0.50-0.89; RD 0.67 fewer events per patient-year; low certainty). Overall, BT may improve asthma control (mean difference -0.37; 95% CI, -0.67 to -0.07; RD for 0.5-point decrease: 15.9% more; low certainty), asthma-related quality of life (mean difference 0.55; 95% CI, 0.28-0.82; RD for 0.5-point increase: 19.1% more; low certainty), and severe exacerbations (IRR 0.81; 95% CI, 0.68-0.97; RD 0.11 fewer events per patient-year; low certainty). Conclusion: Among adults with severe asthma, BT may improve asthma control and asthma-related quality of life and may reduce overall severe exacerbations, but it likely increases procedural severe exacerbations and serious respiratory harms.

Indexed as

Asthmaasthma controlbronchial thermoplastyefficacyexacerbationsGRADEharmsmeta-analysisquality of liferadiofrequency ablationsafetysystematic reviewthermoplasty

Identifiers

PMID41907855
PMCPMC13019930

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.