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Exhaled nitric oxide in childhood allergic asthma management: a randomised controlled trial

Eva J Peirsman1, Thierry J Carvelli, Pierre Y Hage

  • 1Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium.

Pediatric Pulmonology
|September 17, 2013
PubMed

Insights

Fractional exhaled nitric oxide (FeNO) monitoring in children with allergic asthma reduced exacerbations. While symptom-free days didn't improve, FeNO guided treatment increased medication use.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Clinical Trial Research

Background:

  • Allergic asthma management in children requires effective strategies to reduce exacerbations.
  • Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of airway inflammation.
  • Current asthma guidelines may benefit from objective inflammatory markers.

Purpose of the Study:

  • To evaluate the impact of incorporating FeNO measurements into the management of childhood allergic asthma.
  • To assess if FeNO-guided treatment improves health outcomes compared to standard care.

Main Methods:

  • A multicentre, single-blind, randomized controlled trial involving 99 children with persistent allergic asthma.
  • Treatment followed Global Initiative for Asthma (GINA) guidelines, with FeNO group management additionally guided by FeNO levels.
  • Health outcomes were monitored over a 52-week period.

Main Results:

  • The FeNO group experienced significantly fewer asthma exacerbations (24% vs. 48%, P=0.017).
  • No significant difference in the proportion of symptom-free days between groups.
  • Increased use of leukotriene receptor antagonists and higher inhaled corticosteroid doses were observed in the FeNO group.

Conclusions:

  • FeNO-guided management reduced asthma exacerbations in children.
  • While not improving symptom-free days, FeNO monitoring led to increased medication use, including leukotriene receptor antagonists and inhaled corticosteroids.
  • FeNO measurements represent a valuable tool for optimizing asthma control in pediatric patients.
Abstract

Keywords:
airway inflammationasthma exacerbationsinhaled corticosteroidsleukotriene receptor antagonist

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