Acute bronchospasm is one of the life threatening
morbidities of asthma. ElectroCore, an American company, has launched a
self-administering device — GammaCore —that uses the non-invasive vagus
nerve stimulation (nVNS) technique to relieve the spasm. It is still yet to get
FDA approval. Currently, most patients require immediate hospital admission and
administration of inhalers and, sometimes intravenous drugs to stabilize the
The GammaCore device is a small, hand-held device
that should be applied on the skin of the neck over the vagus nerve
for just two minutes.
At the recently concluded 67th
American Academy of Neurology meeting
in Washington DC, the company made a presentation to show that GammaCore does not cause any cardiovascular
problems in patients with asthma
. It reported on
the cardiac effects of using GammaCore in
asthma patients using nVNS to treat acute bronchospasm. It further reinforced
the safety of using GammaCore through
clinical trials and experience with more than 1500 patients.
The 12-Month Trial
The trial was conducted for a year at four centers across the US simultaneously — 284 ECGs were performed on 29 patients
with a history of mild-to-moderate asthma. Each patient had a 12-lead electrocardiograms
performed at three study visits: baseline, stimulation, and follow-up. During the stimulation visit,
ECGs were performed prior to, during, and ≤90 minutes after administration of a
single 120-second nVNS stimulation.
The results showed no clinically significant changes in the ECG, either in
isolated readings or in comparison to baseline. Treatment with nVNS had no effect on heart rate, PR interval, corrected QT interval, or QRS
duration. These findings were reviewed by an independent cardiologist.
However, the doctors are still worried that the
vagus nerve stimulation could cause problems with rhythms of the heart as the
nerve not only supplies lungs but also the heart and abdominal organs.
What is Bronchospasm?
Acute bronchospasm, caused by asthma, is also known
as an asthma attack. Bronchospasm means your air passages have become narrow,
which is caused by inflammation and tightening of the muscles in the air tubes
(bronchi) in your lungs. This makes it hard for you to breathe or makes you to
wheeze and cough.
Also known as asthma attacks, the treatment for
bronchospasm is aimed at reducing inflammation and opening up the airways in
your lungs. Bronchospasm is generally, treated with quick relief or rescue
medicines (bronchodilators) and controller medicines (inhaled corticosteroids).
These are, sometimes, given through an inhaler or a nebulizer. Doctors also
prescribe systemic steroid medicine, which is either a pill you can swallow or
is given through an IV tube. Antibiotic medicines
are used only if there is a
Asthma in Developing Countries
The most recent revised global estimate of asthma
suggests that as many as 334 million people suffer from this respiratory
disorder (Global Burden of Disease Study). The notion that asthma is the
disease of high-income or developed countries is no longer true. Most people
affected belong to the developing countries, and its prevalence is increasing
In 2009, one in 12 people (about 25 million) had
asthma and 53% of people with asthma had an asthma attack in 2008. More
children (57%) than adults (51%) have had an attack. The World Health
Organization estimates India to have 15-20 million asthmatics with 10% and 15%
prevalence among 5- to 11-year-old children. In Brazil, Costa Rica, Panama,
Peru and Uruguay, prevalence of asthma symptoms in children varies from 20% to
30%. In Kenya, it approaches 20%.
On a global scale,
the economic costs of asthma exceed those of Tuberculosis