In moderate-to-severe asthma patients monitoring exhaled nitric oxide during exacerbation is not a good predictor of spirometric response to oral corticosteroid

Gelb, Arthur F.; Moridzadeh, Roxanna; Singh, Deepak H.; Fraser, Christine; George, Steven C.

doi:10.1016/j.jaci.2012.03.036

Cited by 18 publications

(13 citation statements)

References 41 publications

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“…Three trials [7][8][9] found that the utility of exhaled nitric oxide for the management of asthma was of questionable value. The meta-analysis by Jartti et al also questioned the utility of routine use of exhaled nitric oxide.…”

Section: Objective Measures and Assessment Of Lung Functionmentioning

confidence: 99%

Respiratory Care Year in Review 2012: Asthma and Sleep-Disordered Breathing

2013

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Asthma has long been recognized as a common respiratory disease, and the recognition of sleepdisordered breathing is becoming more prevalent. Patients with these disorders are commonly seen by clinicians caring for patients with respiratory disease. There is also much academic interest in asthma and sleep-disordered breathing. The purpose of this paper is to review the recent literature related to asthma and sleep-disordered breathing in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

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Section: Objective Measures and Assessment Of Lung Functionmentioning

confidence: 99%

Respiratory Care Year in Review 2012: Asthma and Sleep-Disordered Breathing

2013

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“…However, a very recent study in adult subjects on inhaled steroids similarly showed that FENO does not consistently increase during severe asthma exacerbations. 8 …”

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confidence: 99%

Asthma in the elderly: The role of exhaled nitric oxide measurements

Columbo

Wong

Panettieri

et al. 2013

Respiratory Medicine

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Summary Asthma in the elderly is poorly understood because only a small minority of asthma studies have investigated this patients group. Fractional Exhaled Nitric Oxide (FENO) has been extensively studied in children and adults with asthma, but little is known about FENO in elderly asthmatics. We studied the role of serial measurements of FENO in elderly subjects with asthma. Thirty stable asthmatics 65 years old and older were followed for one year with evaluations at baseline and every three months. We looked for associations between FENO and subjects’ demographics, comorbidities, asthma treatment, spirometric values and Asthma Control Test (ACT) scores. FENO was not elevated in our study subjects throughout the study period (mean < 30 ppb). FENO significantly increased and FEV1% decreased between first and last study visit, while ACT scores and steroid dose remained unchanged. No significant correlation was found between FENO and FEV1/FVC, other spirometric values, inhaled steroid dose or ACTscores at any time point. No associations of FENO were found with age, sex, Body Mass Index (BMI), atopic status, disease duration, presence of rhinitis or gastroesophageal reflux disease (GERD), or other medications used. Moderate asthma exacerbations did not consistently cause an increase of FENO. In stable elderly asthmatic patients, FENO was not elevated and did not correlate with subjects’ demographics, comorbidities, treatment, symptoms or spirometric values. Routine measurements of FENO may not be clinically valuable in elderly asthmatics.

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“…The lowest labeled dose (88 mcg twice daily (BID)) was associated with responses on or near the plateau of the dose-response curve and responses did not return to baseline levels after the 14-day washout period [40]. Others have shown that ENO on its own cannot provide useful therapeutic information regarding response to ICS [41] or that it could be useful as an adjunct to guide therapy [42].…”

Section: 2mentioning

confidence: 99%