Sunday, July 08, 2007

Trial for asthma

A few days ago, I learned of a fascinating clinical trial that could have implications for people with asthma. The description is on this site.

Here's the deal. Beyond the inflammation that occurs with asthma, the muscular spasm that makes it difficult to breathe is a serious problem. In this trial a catheter that emits RF radiation is used to deliver bronchial thermoplasty that actually reduces the size and functioning of the smooth muscles in the airways that is the home of those spasms.

I know this sounds a bit odd, but apparently the smooth muscle in our airways is vestigial, from the time mammals were amphibious and needed to close their airways while diving under water. (Actually whales still use those muscles to expel water when they surface.) So, if you zap this muscle with RF, it is reduced in size and put out of business. In that state, it cannot create the kind of spasms from which asthmatic people suffer.

The procedure is still in trials, but I thought it was interesting enough to pass along to you. If it works as presented, it could be a huge development in the treatment of this very pervasive disease. Also, if it works as presented, this would be one of those medical developments that actually offers a reduction in the cost of health care.

Addendum on July 16: It has come to my attention that BIDMC has had commercial relationships with the company engaged in these trials. I was not aware of this before today, and I apologize for not mentioning it in my original post. I will consult with the BIDMC contracts office from now on before discussing new therapies and devices on this blog.


Anonymous said...

Paul; I remember when I originally read this post that the link you cited sounded like a commercial. I am curious; how did you become aware of this treatment; through a physician at BIDMC, or a sales rep or what? I thought it curious at the time that you would run across it, unless a family member has asthma.
I was just wondering if you were inadvertantly "used."

Paul Levy said...

Toss away your conspiracy theory. :)

I met the inventor of the process by chance at an ice cream stand on Cape Cod while I was on vacation. It seemed really neat to me, and I wrote it up.

Of course, he knew where I worked, and he knows our doctors. He made clear about that, but he also made clear that the actual clinical trial was being held at Brigham and Women's Hospital. While it turns out that there had been a small contract between BIDMC and his firm in preparation for the trial, we never got into discussions about that at the ice cream stand.

In any event, he had no idea that I was going to write up the topic on my blog. And to be clear, we have no financial interest whatsoever in the commercial success of his company.

BTW, it STILL seems really neat to me. Had I known about the business connection, I STILL would have written it up. I just would have noted the business connection.

Note to others: I am happy to be "used" to write about interesting developments in medicine -- but let's just be careful to disclose any financial ties with BIDMC or our doctors.

Anonymous said...

Wow, that sounds like serendipity and Murphy's Law combined. It does seem to be an innovative approach to the problem,
hope it works.
By the way, I came across the little controversry from Kevin M.D.'s blog. Sounds like the Center for Whatever must have a mechanism for scanning all blogs or something; must be massive!