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Therapeutics
Using exhaled NO concentrations to adjust inhaled corticosteroid dose maintained asthma control and reduced the dose

https://doi.org/10.1136/ebm.11.1.20

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    Smith AD, Cowan JO, Brassett KP, et al. Use of exhaled nitric oxide measurements to guide treatment in chronic asthma. N Engl J Med 2005;352:2163–73.
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 Q In patients with chronic asthma, does optimising the inhaled corticosteroid dose using the fraction of nitric oxide in exhaled air (FENO) reduce asthma exacerbations and the daily dose more than using conventional criteria?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Allergy and immunology ★★★★☆☆☆ Respirology ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    unclear.*

    Embedded ImageBlinding:

    blinded (patients and physician who confirmed dose adjustment decisions).*

    Embedded ImageFollow up period:

    12 months after optimal dose was established.

    Embedded ImageSetting:

    university hospital in Dunedin, New Zealand.

    Embedded ImagePatients:

    97 of 110 recruited patients who were 12–75 years of age (mean age 45 y, 63% women), had chronic asthma being managed in a primary care setting, and had been taking inhaled corticosteroids regularly for ⩾6 months with no change in dose in ⩽6 weeks. Exclusion criteria included ⩾4 courses of oral prednisone in ⩽12 months, admission to hospital for asthma in …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr R Taylor, Dunedin School of Medicine, Dunedin, New Zealand. robin.taylor{at}stonebow.otago.ac.nz

    • Source of funding: GlaxoSmithKline provided fluticasone.

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      BMJ Evidence-Based Medicine 2006; 11 31-31 Published Online First: 30 Jan 2006. doi: 10.1136/ebm.11.1.31-a