TY - JOUR
T1 - The combined impact of exhaled nitric oxide and sputum eosinophils monitoring in asthma treatment: a prospective cohort study
AU - Malerba, Mario
AU - Radaeli, Alessandro
AU - Olivini, Alessia
AU - Ragnoli, Beatrice
AU - Ricciardolo, Fabio
AU - Montuschi, Paolo
PY - 2015
Y1 - 2015
N2 - BACKGROUND: Inhaled corticosteroids (ICS) treatment for asthma control is generally focused on lung function and symptoms, but inadequately correlated with airway inflammation.
OBJECTIVE: To compare asthma control in a group of patients whose treatment was based on fraction of exhaled nitric oxide (FENO) and sputum eosinophils (intervention group) with a group in whom treatment was based on clinical score (control group). Study design and primary outcome: Randomized parallel-group longitudinal 24-month study including 5 visits every 6 months. A combination of asthma exacerbation rate and symptom score at 24 months was the primary outcome.
PARTICIPANTS: Fourteen patients with eosinophilic asthma per group were included.
RESULTS: In the intervention group, exacerbation rate/patient/year was reduced at 12 months (0.82) (-73%) and, to a greater extent at 24 months (0.5) (-84%) compared with baseline (3.21, p<0.01). In the control group, a significant reduction in exacerbation rate/patient/year was only observed between month 12 (3.0) and 24 (2.0, -33%, p<0.01). At 24 months, exacerbation rate was lower (-75%) in the intervention (0.5) than in the control group (2.0, p<0.05). Compared with baseline, mean symptom scores at 24 months were reduced in both groups (intervention group: -72%; control group: - 60%), but were lower in the intervention (8.1±1.0, p<0.05; -27%) than in the control group (11±2.6). ICS dose gradually increased in both groups throughout the study, with no between-group differences
AB - BACKGROUND: Inhaled corticosteroids (ICS) treatment for asthma control is generally focused on lung function and symptoms, but inadequately correlated with airway inflammation.
OBJECTIVE: To compare asthma control in a group of patients whose treatment was based on fraction of exhaled nitric oxide (FENO) and sputum eosinophils (intervention group) with a group in whom treatment was based on clinical score (control group). Study design and primary outcome: Randomized parallel-group longitudinal 24-month study including 5 visits every 6 months. A combination of asthma exacerbation rate and symptom score at 24 months was the primary outcome.
PARTICIPANTS: Fourteen patients with eosinophilic asthma per group were included.
RESULTS: In the intervention group, exacerbation rate/patient/year was reduced at 12 months (0.82) (-73%) and, to a greater extent at 24 months (0.5) (-84%) compared with baseline (3.21, p<0.01). In the control group, a significant reduction in exacerbation rate/patient/year was only observed between month 12 (3.0) and 24 (2.0, -33%, p<0.01). At 24 months, exacerbation rate was lower (-75%) in the intervention (0.5) than in the control group (2.0, p<0.05). Compared with baseline, mean symptom scores at 24 months were reduced in both groups (intervention group: -72%; control group: - 60%), but were lower in the intervention (8.1±1.0, p<0.05; -27%) than in the control group (11±2.6). ICS dose gradually increased in both groups throughout the study, with no between-group differences
KW - asthma
KW - asthma exacerbation rate
KW - asthma symptom score
KW - fraction of exhaled nitric oxide
KW - sputum eosinophils
KW - asthma
KW - asthma exacerbation rate
KW - asthma symptom score
KW - fraction of exhaled nitric oxide
KW - sputum eosinophils
UR - http://hdl.handle.net/10807/71639
U2 - 10.2174/1871524915666150710123415
DO - 10.2174/1871524915666150710123415
M3 - Article
SN - 1381-6128
VL - 21
SP - 4752
EP - 4762
JO - Current Pharmaceutical Design
JF - Current Pharmaceutical Design
ER -