TY - JOUR T1 - Baseline exhaled NO in relation to asthma control improvement after increased dose of inhaled steroids - A real-life study JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P3554 AU - Andrei Malinovschi AU - Alain Michils AU - Sébastien Michiels AU - Alain Van Muylem Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P3554.abstract N2 - Exhaled nitric oxide (FeNO) is a marker of airways inflammation. The ATS clinical guidelines suggest that FeNO > 50 ppb indicate need of stepping-up treatment, but no clear recommendations exist for lower FeNO levels. Therefore we studied, in a real-life setting, the predictive value of FeNO for an improvement of asthma control when stepping up inhaled corticosteroids (ICS).Decision, according to GINA guidelines, to step up ICS was made in 135 (73 women) non-smoking, steroid-treated asthmatics, aged 46 years (range 18-85). FeNO and asthma control (ACQ) were measured at baseline and follow-up (median 98 days). Subjects were grouped upon baseline FeNO in: low (L) (≤25 ppb, n=49), intermediate (I) (>25 and ≤50 ppb, n=46) and high (H) FeNO (>50 ppb, n=40). A sub-analysis was done in subjects who responded by decreasing airway inflammation (FeNO) upon stepping-up ICS (n=73).Similar ICS doses at baseline (p=0.30) and similar dose increases (p=0.24) were prescribed in all three groups. A clinical improvement of ACQ (≥0.5) was more prevalent in I and H (p<0.001), translating into odds ratios (OR) of improving ACQ of 3 (1.2, 7.4) for I and 7 (2.7, 18.1) for H (vs group L). A larger proportion of subjects in groups I and H, compared to group L, improved ACQ and lowered FeNO between visits (63% and 65% vs 20 %, p<0.01 both values), translating into OR of improving ACQ of 6.8 (1.5, 7.4) in group I and 7.3 (2.7, 18) in group H (vs group L).In conclusion, both subjects with intermediate and high FeNO are likely to improve their asthma control when stepping-up treatment. Only one in five subjects with low FeNO further improved asthma control after intensified treatment. ER -