The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: A randomized study

Truong-Thanh, Tung; Vo-Thi-Kim, Anh; Vu-Minh, Thuc; Truong-Viet, Dung; Tran-Van, Huong; Duong‐Quy, Sy

doi:10.1016/j.advms.2020.03.001

Cited by 12 publications

(9 citation statements)

References 22 publications

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“…In the ninth RCT, no significant difference was found in median ACQ score (FeNO group: 0.8 (IQR 0.4 to 1.8); control group: 0.8 (IQR 0.4 to 2); p = .7) 26 . In addition, one RCT reported on asthma control measured by ACT (where higher scores indicate better asthma control) at final visit, and found no significant difference in mean scores (MD = −1 (95%CI −2.63 to 0.63)) 29 …”

Section: Resultsmentioning

confidence: 97%

Effectiveness of FeNO‐guided treatment in adult asthma patients: A systematic review and meta‐analysis

Korevaar

Damen

Heus

et al. 2023

Clin Experimental Allergy

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ObjectiveAsthma control is generally monitored by assessing symptoms and lung function. However, optimal treatment is also dependent on the type and extent of airway inflammation. Fraction of exhaled Nitric Oxide (FeNO) is a noninvasive biomarker of type 2 airway inflammation, but its effectiveness in guiding asthma treatment remains disputed. We performed a systematic review and meta‐analysis to obtain summary estimates of the effectiveness of FeNO‐guided asthma treatment.DesignWe updated a Cochrane systematic review from 2016. Cochrane Risk of Bias tool was used to assess risk of bias. Inverse‐variance random‐effects meta‐analysis was performed. Certainty of evidence was assessed using GRADE. Subgroup analyses were performed based on asthma severity, asthma control, allergy/atopy, pregnancy and obesity.Data SourcesThe Cochrane Airways Group Trials Register was searched on 9 May 2023.Eligibility CriteriaWe included randomized controlled trials (RCTs) comparing the effectiveness of a FeNO‐guided treatment versus usual (symptom‐guided) treatment in adult asthma patients.ResultsWe included 12 RCTs (2,116 patients), all showing high or unclear risk of bias in at least one domain. Five RCTs reported support from a FeNO manufacturer. FeNO‐guided treatment probably reduces the number of patients having ≥1 exacerbation (OR = 0.61; 95%CI 0.44 to 0.83; six RCTs; GRADE moderate certainty) and exacerbation rate (RR = 0.67; 95%CI 0.54 to 0.82; six RCTs; moderate certainty), and may slightly improve Asthma Control Questionnaire score (MD = −0.10; 95%CI −0.18 to −0.02, six RCTs; low certainty), however, this change is unlikely to be clinically important. An effect on severe exacerbations, quality of life, FEV1, treatment dosage and FeNO values could not be demonstrated. There were no indications that effectiveness is different in subgroups of patients, although evidence for subgroup analysis was limited.ConclusionsFeNO‐guided asthma treatment probably results in fewer exacerbations but may not have clinically important effects on other asthma outcomes.

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Section: Resultsmentioning

confidence: 97%

Effectiveness of FeNO‐guided treatment in adult asthma patients: A systematic review and meta‐analysis

Korevaar

Damen

Heus

et al. 2023

Clin Experimental Allergy

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“…An elevated FeNO level reflects the allergic airway inflammation in asthmatic patients and may be correlated with treatment response. Truong-Thanh et al 8 state that in asthma patients with a high FeNO level, a higher dose of inhaled corticosteroids (ICS) may be needed to achieve a better response. A literature search did not reveal any additional information to support or refuse this.…”

Section: Discussionmentioning

confidence: 99%

Knowledge of fractional exhaled nitric oxide use among doctors working in a local respiratory department

Bonello¹,

Bianco²,

Gouder³

2023

Pneumon

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“…Regarding the cost of asthma treatment by using FeNO for the titration of the ICS dose, some previous studies have been published. [24][25][26] Truong-Thanh et al 24 conducted a prospective and randomized study to demonstrate the role of FeNO in association with GINA guidelines for treatment of adult patients with asthma. The study involved 176 patients followed up 9 months.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of the Use of FeNO for the Diagnosis and Management of Asthma Patients in Primary Care in Sweden

Darbà¹,

Ascanio²,

Syk³

et al. 2021

CEOR

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The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: A randomized study

Cited by 12 publications

References 22 publications

Effectiveness of FeNO‐guided treatment in adult asthma patients: A systematic review and meta‐analysis

Effectiveness of FeNO‐guided treatment in adult asthma patients: A systematic review and meta‐analysis

Knowledge of fractional exhaled nitric oxide use among doctors working in a local respiratory department

Economic Evaluation of the Use of FeNO for the Diagnosis and Management of Asthma Patients in Primary Care in Sweden

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