Dual-center randomised trial on tailored asthma therapy based on exhaled nitric oxide (FeNO) versus routine clinical care | Health & Environmental Research Online (HERO)

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Citation
Tags

HERO ID

2266938

Reference Type

Journal Article

Subtype

Abstract

Title

Dual-center randomised trial on tailored asthma therapy based on exhaled nitric oxide (FeNO) versus routine clinical care

Author(s)

Petsky, H; Li, AM; Kynaston, JA; Turner, C; Chang, AB

Year

2010

Is Peer Reviewed?

Yes

Journal

American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970

Volume

181

Page Numbers

A3928

Language

English

DOI

10.1164/ajrccm-conference.2010.181.1_MeetingAbstracts.A3928

Web of Science Id

WOS:000208771003277

Relationship(s)

is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans

Abstract

Our Cochrane review examining the efficacy of using FeNO to tailor the dose of inhaled corticosteroid showed that FeNO cannot be routinely recommended for clinical practice at this stage and remains uncertain. However all the 6 studies used a single FeNO cut-off. In this RCT we determined if asthma monitoring using FeNO (using 2 different cut-offs dependent on atopy) is better than control (symptoms and FEV1) in preventing asthma exacerbations in children on inhaled corticosteroids.

Methods: Over 12-months, children underwent spirometry, FeNO, QOL and asthma/cough diary during every visit. Treatment for asthma was adjusted according to pre-determined criteria taking into account atopy status and dependent on allocation group (FeNO or control).

Results: 63 children were randomised- FeNO group (N=31, median age 10.2, IQR 5.75), or control group (N=32, median age 10.1, IQR 5.69). Significantly fewer children in the FeNO group had asthma exacerbations compared to the control group (6 vs 15; p=0.021) over 12-months. Number needed to treat (NNT) to prevent one child from having any exacerbation in 12 months = 4 (95%CI 3, 24).

Conclusion: Tailoring of asthma medications in accordance to FeNO levels (compared to usual management), taking into account atopy status, reduces asthma exacerbations and improves asthma QOL. However both strategies equally improved FEV1.

Conference Name

American Thoracic Society 2010 International Conference

Conference Location

New Orleans, LA

Conference Dates

May 14-19, 2010