PT  - JOURNAL ARTICLE
AU  - Susanne Vijverberg
AU  - Ellen Koster
AU  - Leo Koenderman
AU  - Dirkje Postma
AU  - Gerard Koppelman
AU  - Kors van der Ent
AU  - Jan Raaijmakers
AU  - Anke-Hilse Maitland-van der Zee
TI  - Factors associated with high levels of exhaled NO in children using asthma medication
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3280
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3280.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3280.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Background: A high fractional nitric oxide concentration in exhaled breath (FeNO) is thought to be a marker of ongoing airway inflammation and may reflect poor asthma control.Objectives: To study factors associated with high FeNO in children using asthma medication.Methods: Our study population consists of 602 children (age 4-12 years) who used asthma medication in the past year and participated in the PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with ANti-inflammatory effects)-cohort study. FeNO was measured using an electrochemical hand-held device (Niox Mino, Aerocrine, Sweden). Data on respiratory symptoms, medication use, therapy adherence and environmental factors were collected using a questionnaire. Asthma control was defined using the Asthma Control Questionnaire (ACQ). Children with high FeNO (>25 ppb) were compared to children with normal FeNO (5-25 pbb). Logistic regression analysis was used to study factors associated with high FeNO.Results: FeNO could be measured in 501 children (83%); FeNO was high in 134 children (27%). Children with high FeNO were older than children with normal FeNO (mean age: 9.8 vs 8.7 years, p<0.01). In addition, high FeNO was associated with a lower chance of good adherence to asthma medication (OR: 0.4; 95%CI 0.2-0.6) and a lower chance of well-controlled asthma according to the ACQ (OR 0.5; 95%CI 0.4-0.8).Conclusions: In our cohort of children using asthma medication, high FeNO is associated with higher age, lower adherence and less well-controlled asthma at population level. Further research is necessary to assess the value of FeNO for the individual patient.