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FeNO-guided management effectively eases asthma flare-ups, improves asthma control, and lowers inhaled corticosteroid use in adults with asthma.
In a systematic review and meta-analysis published in “Respiratory Investigation”, fractional exhaled nitric oxide (FeNO)-guided management reduced asthma exacerbations and medication dependence but did not markedly impact severe exacerbations, lung function, or quality of life. The goal was to evaluate the impact of FeNO-directed treatment compared to conventional asthma treatment, especially focusing on exacerbation rates and treatment responses.
This study by Hiroaki Tsurumaki et al. updated a 2016 Cochrane review by incorporating 6 new randomized controlled trials (RCTs), each with a treatment duration of ≥12 weeks. A sub-analysis was carried out on 2 groups: FeNO-alone and FeNO along with symptom score. In 13 RCTs, FeNO-guided management successfully minimized asthma exacerbations and their frequency per 52 weeks, while slightly improving asthma control and reducing the need for inhaled corticosteroids.
However, it showed no vital impact on severe exacerbations, forced expiratory volume in 1 second (FEV1), FeNO levels, or asthma-associated quality of life. Subgroup assessment revealed that both FeNO alone and FeNO in combination with symptom scores were equally beneficial in decreasing aggravations compared to conventional care. This study suggests that while FeNO-guided strategy may not substantially impact all aspects of asthma care, it holds promise as an efficient tool in lessening exacerbations and optimizing treatment, paving the way for more personalized asthma management in adults.
Respiratory Investigation
Assessing the utility of fractional exhaled nitric oxide-guided management in adult patients with asthma: A systematic review and meta-analysis
Hiroaki Tsurumaki et al.
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