RT Journal Article SR Electronic T1 Tapering oral corticosteroids in severe asthma is associated with a decrease in fractional exhaled nitric oxide JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 355 VO 38 IS Suppl 55 A1 Simone Hashimoto A1 Anneke Ten Brinke A1 Jacob K. Sont A1 Aeilko H. Zwinderman A1 Peter J. Sterk A1 Elisabeth H. Bel YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/355.abstract AB Rationale: In a recent oral corticosteroid tapering study in patients with severe asthma (Hashimoto ATS 2010), we observed high levels of exhaled nitric oxide (FENO) despite high doses of oral corticosteroids, and, unexpectedly (Smith NEJM 2005), only a minor role of FENO in adjusting the dose.Hypothesis: Changes in FENO values in patients with severe prednisone-dependent asthma are not associated with changes in corticosteroid dose or clinical parameters.Aim/Method: 48 adult patients with severe, prednisone dependent asthma (mean (SD) age 49.4 (12.2) y; 18 male) were included in this 6 months follow-up study. Relationships between changes in daily FENO and oral corticosteroid dose, asthma control (ACQ), and FEV1 were assessed. Pearson correlation and regression analyses were used.Results: Baseline median (range) FENO and prednisone were 38 (5-300) pbb and 10 (0-60) mg/day. Daily changes in FENO from baseline were positively associated with daily changes in prednisone dose (r=0.22, p=0.003) but not with FEV1 (r=-0.02, p=0.77) or ACQ (r=-0.03, p=0.65).Conclusion: In contrast to patients with mild-moderate asthma, patients with severe, prednisone dependent asthma show a decrease in FENO levels when prednisone is tapered.Implication: This suggests that oral corticosteroids may contribute to persistently high levels of FENO in severe asthma.