%0 Journal Article %A William Anderson %A Philip Short %A Peter Williamson %A Brian Lipworth %T Effects of inhaled corticosteroids on asthmatic inflammation: The FeNOtype trial %D 2012 %J European Respiratory Journal %P P2088 %V 40 %N Suppl 56 %X BACKGROUND: Personalised treatment for inflammatory asthma phenotypes confers superior benefits. The elevated exhaled nitric oxide (FeNO) inflammatory phenotype requires evaluation of dose-response to inhaled corticosteroids (ICS).METHODS: Randomised, crossover trial in mild-to-moderate asthmatics receiving ICS with elevated FeNO>40ppb after ICS washout. Patients received 2 weeks of: fluticasone propionate 50ug twice-daily (FP100) or 250ug twice-daily (FP500). Primary outcome: response in diurnal domiciliary FeNO levels. Secondary outcomes included: mannitol challenge; serum eosinophilic cationic protein (ECP); blood eosinophil count; and asthma control questionnaire (ACQ).RESULTS: 21 patients completed. We found significant dose-related reductions of diurnal FeNO compared to baseline: am FeNO: baseline=71ppb; FP100=34ppb, p<0.001; FP500=27ppb, p<0.001; and significant dose separation for am, p<0.05, and pm, p<0.001. Time series FeNO displayed exponential decay:ACQ significantly improved exceeding the minimal important difference (>0.5) with values in keeping with controlled asthma (<0.75) after each dose: FP100=0.48, p=0.004; FP500=0.37, p=0.001. All other secondary inflammatory related outcomes showed significant improvements from baseline but no dose separation.CONCLUSION: There is significant, dose-response of diurnal FeNO to ICS in patients with a high FeNO phenotype, also associated with well controlled asthma. %U https://erj.ersjournals.com/content/erj/40/Suppl_56/P2088.full.pdf