RT Journal Article
SR Electronic
T1 FeNO in children with asthma is related to inhaled corticosteroids adherence, not to asthma control
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4204
VO 44
IS Suppl 58
A1 Ted Klok
A1 Ad Kaptein
A1 Paul Brand
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P4204.abstract
AB IntroductionThe fraction of nitric oxide in exhaled breath (FeNO) is associated with asthma control, but also with the use of inhaled corticosteroids (ICS). We assessed whether FeNO was associated with asthma control after adjusting for exposure to ICS, objectively assessed by electronic adherence measurements.MethodsChildren (5-12 yrs) with asthma, who received comprehensive care in our hospital-based asthma clinic, participated in a 1-yr follow-up study, during which adherence to ICS was measured electronically. FeNO and lung function were measured between 6 and 12 months of follow-up. Asthma control was assessed by Asthma Control Questionnaire (ACQ), Paediatric Asthma Caregiver Quality Of Life questionnaire (PACQOL), by overall physician assessment on a Visual Analogue Scale and by recording exacerbations during the study year. Multivariate analysis was used to study the relationship of FeNO to both ICS adherence and asthma control, adjusting for patient characteristics such as age, atopy and parental smoking.ResultsThe median FeNO of 58 children (median age 6.9 yrs, interquartile range [IQR] 5 – 9 yrs) was 15 ppb (IQR 15 – 21 ppb). The median (IQR) long-term adherence was 82% (58 – 90%). Low FeNO was associated with high adherence (ρ -0.42, p0.001) and with asthma control as assessed by lung function measurement and by the physician. In the multivariate analysis, ICS adherence was the only independent determinant of FeNO. This relationship was not influenced by characteristics of the children or their parents.ConclusionAdherence to ICS determines both FeNO and asthma control in this study cohort.