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Title: Measuring Exhaled Nitric Oxide Does Not Improve Asthma Control
URL: http://www.pslgroup.com/dg/22CC26.htm
Doctor's Guide
September 18, 2008

NEW YORK -- September 18, 2008 -- Measuring exhaled nitric oxide (NO) fractions from the breath of asthma patients does not clinically improve asthma control when combined with conventional management assessing symptoms and lung function, according to a study published in the Asthma Special Issue of The Lancet.

Stanley J. Szefler, MD, National Jewish Health, Denver, Colorado, and colleagues from the National Institute of Allergy and Infectious Diseases, National Institutes of Health Inner City Asthma Consortium, Bethesda, Maryland, conducted a randomised controlled trial in patients aged 12 to 20 years who were randomly assigned to a 46-week treatment period of either conventional management (control) or conventional management plus NO monitoring.

The researchers found that the number of days with asthma symptoms did not differ between groups, nor did lung function or worsening of asthma symptoms. However, patients in the NO monitoring group received higher doses of inhaled corticosteroids -- around 28% higher than controls (550 vs 431 mcg/day).

"Conventional asthma management resulted in good control of symptoms in most participants. The addition of fraction of exhaled NO as an indicator of control of asthma resulted in higher doses of inhaled corticosteroids, without clinically important improvements in symptomatic asthma control," the authors wrote.

In an accompanying comment, Søren Pedersen, MD, Kolding Hospital, Kolding, Denmark, and Paul O'Byrne, MD, McMaster University, Hamilton, Ontario said: "More studies are needed to explore the usefulness of exhaled nitric oxide in subgroups of patients with asthma and its treatment-saving potential. Until such data are available, a recommendation to use exhaled nitric oxide measurements routinely in patients treated according to guidelines is not ready to be made yet."

SOURCE: The Lancet

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