RT Journal Article
SR Electronic
T1 Domiciliary diurnal variation of fractional exhaled nitric oxide for asthma control
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00485-2013
DO 10.1183/09031936.00048513
A1 Junpei Saito
A1 David Gibeon
A1 Patricia Macedo
A1 Andrew Menzies-Gow
A1 Pankaj K Bhavsar
A1 Kian Fan Chung
YR 2013
UL http://erj.ersjournals.com/content/early/2013/08/15/09031936.00048513.abstract
AB A major goal of asthma management is maintaining optimal control. Current assessment is based on symptoms and lung function.We evaluated whether domiciliary daily home FeNO monitoring could be useful as an index of asthma control.Fifty asthmatic subjects and 15 healthy volunteers with a range of asthma severity underwent asthma control questionnaire (ACQ), spirometry before and after salbutamol and sputum induction. FeNO and peak expiratory flow (PEF) were measured twice daily for 2 weeks. A record of exacerbations was obtained 3 months later.Diurnal FeNO variation in uncontrolled asthmatics was significantly greater than in controlled asthmatics (p<0.01). PEF variation was not different. The daily variation of FeNO levels was also greater in uncontrolled asthmatics compared to controlled asthmatic and healthy subjects (p<0.01). 80% of uncontrolled asthmatics experienced at least one or more exacerbations over the 3 months after the enrolment. The combination of diurnal FeNO variation ≥16.6% and ACQ scores ≥1.8 was best at predicting uncontrolled asthma (AUC; 0.91, 95%CI: 0.86–0.97, p<0.001).Diurnal variation in FeNO can be used as a biomarker of asthma control and as a predictor of the risk of future exacerbation. Prospective studies are warranted.