Pike, K;
Selby, A;
Price, S;
Warner, J;
Connett, G;
Legg, J;
Lucas, JSA;
... Roberts, G; + view all
(2013)
Exhaled nitric oxide monitoring does not reduce exacerbation frequency or inhaled corticosteroid dose in paediatric asthma: a randomised controlled trial.
The Clinical Respiratory Journal
, 7
(2)
pp. 204-213.
10.1111/j.1752-699X.2012.00306.x.
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Abstract
Introduction: Inhaled corticosteroid therapy (ICS) for asthma is currently modified according to symptoms and lung function. Fractional exhaled nitric oxide (FENO) has been demonstrated to be a non-invasive marker of eosinophilic inflammation. Studies of FENO-driven asthma management show variable success. / Objectives: This study aimed to evaluate whether monitoring FENO can improve outpatient management of children with moderate to severe asthma using a pragmatic design. / Methods: Children aged 6–17 years with moderate to severe asthma were recruited. Their asthma was stabilised before randomisation to FENO-driven therapy or to a standard management group where therapy was driven by conventional markers of asthma control. ICS or long-acting bronchodilator therapies were altered according to FENO levels in combination with reported symptoms in the FENO group. Participants were assessed 2 monthly for 12 months. ICS dose and exacerbation frequency change were compared between groups in an intention to treat analysis. / Results: Ninety children were randomised. No difference was found between the two groups in either change in corticosteroid dose or exacerbation frequency. Results were similar in a planned secondary analysis of atopic asthmatics. / Conclusion: FENO-guided ICS titration does not appear to reduce corticosteroid usage or exacerbation frequency in paediatric outpatients with moderate to severe asthma. This may reflect limitations in FENO-driven management algorithms, as there are now concerns that FENO levels relate to atopy as much as they relate to asthma control.
| Type: | Article |
|---|---|
| Title: | Exhaled nitric oxide monitoring does not reduce exacerbation frequency or inhaled corticosteroid dose in paediatric asthma: a randomised controlled trial |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/j.1752-699X.2012.00306.x |
| Publisher version: | http://dx.doi.org/10.1111/j.1752-699X.2012.00306.x |
| Language: | English |
| Additional information: | This is the peer reviewed version of the following article: Pike, K; Selby, A; Price, S; Warner, J; Connett, G; Legg, J; Lucas, JSA; (2013) Exhaled nitric oxide monitoring does not reduce exacerbation frequency or inhaled corticosteroid dose in paediatric asthma: a randomised controlled trial. The Clinical Respiratory Journal, 7 (2) pp. 204-213, which has been published in final form at: http://dx.doi.org/10.1111/j.1752-699X.2012.00306.x. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms). |
| Keywords: | asthma; exhaled airway markers; paediatric; therapy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1461333 |
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