UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Exhaled nitric oxide monitoring does not reduce exacerbation frequency or inhaled corticosteroid dose in paediatric asthma: a randomised controlled trial

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. Green open access

[thumbnail of Pike_FeNOclinrespv2.pdf]
Preview
Text
Pike_FeNOclinrespv2.pdf

Download (313kB) | Preview

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
Downloads since deposit
318Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item