Predictive value of exhaled nitric oxide in the management of asthma: a systematic review
| Autor: | Sirpa-Liisa Hovi, Jaana Isojärvi, Eeva Mäkinen, Anneli Ahovuo-Saloranta, Lauri Lehtimäki, Péter Csonka |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Pathology medicine.medical_specialty Adolescent Exacerbation Nitric Oxide Young Adult 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Predictive Value of Tests Internal medicine Eosinophilic Humans Medicine Anti-Asthmatic Agents Prospective Studies 030212 general & internal medicine Young adult Child Prospective cohort study Aged Asthma Inflammation business.industry Exhalation Middle Aged Prognosis medicine.disease Phenotype Treatment Outcome Breath Tests 030228 respiratory system Child Preschool Predictive value of tests Exhaled nitric oxide Female business |
| Zdroj: | European Respiratory Journal. 48:706-714 |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/13993003.00699-2016 |
| Popis: | The clinical value of measuring fractional exhaled nitric oxide (FeNO) in asthma is not clear. We aimed to assess whether FeNO can reliably predict clinical outcomes in asthma treated with inhaled corticosteroids (ICS). We also evaluated whether its predictive role is influenced by different inflammatory phenotypes of asthma.We conducted a systematic review focusing on five clinically relevant questions. Two authors independently screened search results, extracted data and assessed quality of the included studies. Data were synthesised by qualitative methods.12 prospective studies were included, answering partly three of the five questions. In steroid-naïve asthma, a high FeNO level probably predicts good response to ICS. In ICS-treated asthmatics, a low FeNO level probably predicts low risk of exacerbation, and the patient is unlikely to benefit from increasing ICS dose. There were scarce data to conclude whether FeNO predicts exacerbations when ICS treatment is stopped in well-controlled asthma. Only one study reported results separately in different asthma phenotypes.The current evidence on the predictive value of FeNO and its role in the management of asthma is incomplete. Future studies should focus on clinically meaningful questions and probably target only eosinophilic phenotypes where FeNO is best associated with the activity of airway inflammation. |
| Databáze: | OpenAIRE |
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