Utility of fractional exhaled nitric oxide suppression as a prediction tool for progression to biologic therapy
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作者:
Butler, Claire A.
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机构:
Belfast City Hosp, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Butler, Claire A.
[1
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McMichael, Alan J.
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机构:
Queens Univ Belfast, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
McMichael, Alan J.
[2
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Honeyford, Kirsty
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机构:
Belfast City Hosp, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Honeyford, Kirsty
[1
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Wright, Louise
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机构:
Belfast City Hosp, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Wright, Louise
[1
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Logan, Jayne
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机构:
Belfast City Hosp, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Logan, Jayne
[1
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Holmes, Joshua
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机构:
Queens Univ Belfast, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Holmes, Joshua
[2
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Busby, John
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机构:
Queens Univ Belfast, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Busby, John
[2
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Hanratty, Catherine E.
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机构:
Belfast City Hosp, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Hanratty, Catherine E.
[1
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Yang, Freda
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机构:
Gartnavel Royal Hosp, Glasgow, Lanark, Scotland
Univ Glasgow, Glasgow, Lanark, ScotlandBelfast City Hosp, Belfast, Antrim, North Ireland
Yang, Freda
[3
,4
]
Smith, Steven J.
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机构:
Gartnavel Royal Hosp, Glasgow, Lanark, Scotland
Univ Glasgow, Glasgow, Lanark, ScotlandBelfast City Hosp, Belfast, Antrim, North Ireland
Smith, Steven J.
[3
,4
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Murray, Kirsty
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机构:
Gartnavel Royal Hosp, Glasgow, Lanark, Scotland
Univ Glasgow, Glasgow, Lanark, ScotlandBelfast City Hosp, Belfast, Antrim, North Ireland
Murray, Kirsty
[3
,4
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Chaudhuri, Rekha
[3
,4
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Heaney, Liam G.
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机构:
Belfast City Hosp, Belfast, Antrim, North Ireland
Queens Univ Belfast, Belfast, Antrim, North IrelandBelfast City Hosp, Belfast, Antrim, North Ireland
Heaney, Liam G.
[1
,2
]
机构:
[1] Belfast City Hosp, Belfast, Antrim, North Ireland
[2] Queens Univ Belfast, Belfast, Antrim, North Ireland
[3] Gartnavel Royal Hosp, Glasgow, Lanark, Scotland
Rationale: The utility of fractional exhaled nitric oxide (F-ENO) suppression (FeNOSuppT) to identify non-adherence to inhaled corticosteroid (ICS) treatment has previously been reported, but whether it can predict clinical outcome remains unclear. Objectives: We examined the utility of FeNOSuppT in prediction of progression to biologic agents or discharge from specialist care. Methods: FeNOSuppT was measured at home using remote monitoring technology of inhaler use alongside daily F-ENO measurement over 7 days. Long-term clinical outcomes in terms of progression to biologic agent or discharge from specialist care were compared for non-suppressors and suppressors. Measurements and main results: Of the 162 subjects, 135 successfully completed the test with 81 (60%) positive F-ENO suppression tests. Subjects with a negative FeNOSuppT were more likely to proceed to biologic therapy (39 of 54 patients, 72%) compared to those with a positive FeNOSuppT (35 of 81 patients, 43%, p=0.001). In subjects with a positive FeNOSuppT, predictors of progression to biologic therapy included higher dose of maintenance steroid at initial assessment and prior intensive care unit admission. These subjects had a significant rise in F-ENO between post-suppression test and follow-up (median, 33 (IQR 25-55) versus 71 (IQR 24-114); p=0.009), which was not explained by altered corticosteroid dose. Conclusions: A negative FeNOSuppT correlates with progression to biologic therapy. A positive FeNOSuppT, with subsequent maintenance of "optimised" F-ENO, predicts a subgroup of patients in whom asthma control is preserved with adherence to high-dose ICS/long-acting beta 2 agonist and who can be discharged from specialist care.
机构:
Chungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Chungbuk Natl Univ, Med Res Inst, Cheongju 361763, South KoreaChungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Woo, Sung-Il
Lee, Ji-Hyuk
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机构:
Chungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Chungbuk Natl Univ, Med Res Inst, Cheongju 361763, South KoreaChungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Lee, Ji-Hyuk
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机构:
Kim, Heon
Kang, Jong-Won
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机构:
Chungbuk Natl Univ, Med Res Inst, Cheongju 361763, South Korea
Chungbuk Natl Univ, Coll Med, Dept Prevent Med, Cheongju 361763, South KoreaChungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Kang, Jong-Won
Sun, Yong-Han
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机构:
Chungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
Chungbuk Natl Univ, Med Res Inst, Cheongju 361763, South Korea
Gachon Univ Med & Sci, Gil Hosp, Dept Pediat, Inchon, South KoreaChungbuk Natl Univ, Coll Med, Dept Pediat, Cheongju 361763, South Korea
机构:
Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
See, Y. Y.
Chow, E. C. Y.
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机构:
Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
Chow, E. C. Y.
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Crooks, M.
Robinson, M.
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Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
Robinson, M.
Watkins, K.
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Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
Watkins, K.
Turner, F.
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Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
Turner, F.
Thompson, J.
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Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
Thompson, J.
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Faruqi, S.
Chow, E. C. Y.
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机构:
Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, EnglandHull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England
机构:Universidad de Antioquia,Department of Pharmacology and Toxicology, School of Medicine, Research Group in Pharmacology and Toxicology (INFARTO), Facultad de Medicina
Jefferson Antonio Buendía
Ranniery Acuña-Cordero
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机构:Universidad de Antioquia,Department of Pharmacology and Toxicology, School of Medicine, Research Group in Pharmacology and Toxicology (INFARTO), Facultad de Medicina
Ranniery Acuña-Cordero
Carlos E. Rodriguez-Martinez
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机构:Universidad de Antioquia,Department of Pharmacology and Toxicology, School of Medicine, Research Group in Pharmacology and Toxicology (INFARTO), Facultad de Medicina