Exhaled nitric oxide as a guiding tool for bronchial asthma: A randomised controlled trial |
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| Affiliation: | 1. Classified Specialist (Respiratory Medicine), Military Hospital (Cardio Thoracic Centre), Pune 411040, India;2. Graded Specialist (Radiology), Command Hospital (Southern Command), Pune 411040, India;3. Senior Advisor (Medicine & Respiratory Medicine) & Head, Military Hospital (Cardio Thoracic Centre), Pune 411040, India;4. Consultant (Medicine & Respiratory Medicine) & Head, Army Hospital (R&R), Delhi 110010, India;1. Resident, Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;2. Associate Professor (Pediatrics & Pediatric Nephrology), Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;3. Associate Professor (Pediatrics & Pediatric Intensive Care), Department of Pediatrics, Armed Forces Medical College, Pune 411040, India;4. Classified Specialist (Pediatrics and Pediatric Nephrology), Command Hospital (Southern Command), Pune 411040, India;5. Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India;6. Dean & Deputy Commandant, Armed Forces Medical College, Pune 411040, India;1. Resident, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India;2. Consultant (Ophthalmology), Command Hospital (Eastern Command), Kolkata, India;3. Professor (Ophthalmology), Command Hospital (Air Force), Bengaluru 07, India;4. Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India;1. Senior Advisor (Nephrology), Army Hospital (Research & Referral), Delhi, India;2. Senior Resident (Nephrology), Army Hospital (Research & Referral), Delhi, India;3. Classified Specialist, (Nephrology), Army Hospital (Research & Referral), Delhi, India;1. Graded Specialist (Pathology), Command Hospital (Southern Command), Pune 411040, India;2. Commanding Officer, Armed Forces Transfusion Centre, Delhi 110010, India;3. Consultant Pathologist, Apollo Hospitals, Kolkata, India;1. Assistant Professor, Department of Dermatology & Ven, Armed Forces Medical College, Pune 411040, India;2. Resident, Department of Dermatology & Ven, Armed Forces Medical College, Pune 411040, India;3. Senior Advisor (Dermatology), Base Hospital Lucknow, India;4. Professor & Head (Dermatology), Command Hospital (Southern Command), Pune 411040, India |
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| Abstract: | BackgroundEvidence regarding the role of non-invasive marker of airway inflammation, fractional exhaled nitric oxide (FeNO) to guide asthma treatment is equivocal. We aimed to evaluate if the use of FeNO to adjust inhaled corticosteroid treatment resulted in reduced daily corticosteroid use and lesser exacerbations.Methods100 patients of bronchial asthma in the age group of 12–70 years were randomised to receive inhaled corticosteroids based on either FeNO measurements (n = 50) or as per Global Initiative for Asthma (GINA) guidelines. Follow up was done every 2 months for period of 12 months. Results were compared in terms of mean daily inhaled corticosteroid use and number of exacerbations.ResultsAfter the follow up period of 12 months, mean daily dose of ICS (SD) required in FeNO group was 267.5 μg (126.29), as opposed to control group in which mean daily dose of steroid was 320.00 μg (138.69). However this observed difference in steroid dose was statistically insignificant (p value = 0.061). The estimated mean (SD) rate of asthma exacerbation experienced in follow up period of 12 months in FeNO group was 0.3 episodes (0.54) per patient per year (95% confidence interval, 0.145–455) and 0.4 episodes (0.61) per patient per year in control group (95% confidence interval, 0.228–572). However this difference in rate of exacerbations between the two study groups was not statistically significant (p = 0.387).ConclusionFeNO guided management strategy for asthma did not result in statistically significant reduction in dose of inhaled corticosteroids or number of asthma exacerbations. |
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| Keywords: | Exhaled nitric oxide Bronchial asthma Inhaled corticosteroids |
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