Childhood asthma management guided by repeated FeNO measurements: a meta-analysis.
The fraction of exhaled nitric oxide (FeNO) has gained interest as a non-invasive tool to measure airway inflammation in asthma since it reflects allergic inflammation. Recent controlled clinical studies have, however, questioned its role in the management of asthma in children. To assess the clinical value of FeNO in paediatric asthma management, a meta-analysis was performed on the controlled studies of childhood asthma management guided by repeated FeNO measurements, and relevant publications on the confounders of FeNO were reviewed. The data suggests that utilising FeNO to tailor the dose of inhaled corticosteroids in children cannot be recommended for routine clinical practice since there is a danger of excessive inhaled corticosteroid doses in children without meaningful changes in clinical outcomes. Many disease and non-disease related factors (most importantly atopy, height/age and infection) affect FeNO levels which can easily confound the interpretation.
The Departments of Paediatrics, Turku University Hospital, Turku, Finland. tuomas.jartti@utu.fi
Tuomas
T
Jartti
Maria
M
Wendelin-Saarenhovi
Inka
I
Heinonen
Jaakko
J
Hartiala
Timo
T
Vanto
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000730:Androstadienes / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000628:therapy*; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D019819:Budesonide / Q000008:administration & dosage; D002648:Child; D019468:Disease Management; D000068298:Fluticasone; D006801:Humans; D009569:Nitric Oxide / Q000032:analysis*
D000305:Adrenal Cortex Hormones; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D009569:Nitric Oxide; D019819:Budesonide; D000068298:Fluticasone