title: Exhaled nitric oxide fraction as an add-on to ACQ-7 for not well controlled asthma detection.
abstract: BACKGROUND
  The measurement of fractional nitric oxide concentration in exhaled breath (FeNO), a noninvasive indicator of airway inflammation, remains controversial as a tool to assess asthma control. Guidelines currently limit asthma control assessment to symptom and spirometry based appraisals such as the Asthma Control Questionnaire-7 (ACQ-7). We aimed at determining whether adding FeNO to ACQ-7 improves current asthma clinical control assessment, through enhanced detection of not well controlled asthma.
  
  
  METHODS
  Asthmatic subjects, classified as not well controlled as per ACQ-7 on regular clinical practice, were included in a prospective, multicenter fashion, and had their maintenance treatment adjusted on visit 1. On follow-up (visit 2) four weeks later, the subjects were reevaluated as controlled or not well controlled using ACQ-7 versus a combination of FeNO and ACQ-7.
  
  
  RESULTS
  Out of 381 subjects enrolled, 225 (59.1%) had not well controlled asthma on visit 2 as determined by ACQ-7, and 264 (69.3%) as per combined FeNO and ACQ-7. The combination of FeNO to ACQ-7 increased by 14.8% the detection of not well controlled asthma following maintenance therapy adjustment.
  
  
  CONCLUSIONS
  The addition of FeNO to ACQ-7 increased the detectability of not well controlled asthma upon adjustment of maintenance therapy. Adding a measure of airway inflammation to usual symptom and spirometry based scores increases the efficacy of current asthma clinical control assessment.
authors.affiliation: Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona Respiratory Network (BRN), Barcelona, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Plaza
authors.forename: David
authors.initials: D
authors.lastname: Ramos-Barbón
authors.forename: Ana María
authors.initials: AM
authors.lastname: Muñoz
authors.forename: Ana María
authors.initials: AM
authors.lastname: Fortuna
authors.forename: Astrid
authors.initials: A
authors.lastname: Crespo
authors.forename: Cristina
authors.initials: C
authors.lastname: Murio
authors.forename: Rosa
authors.initials: R
authors.lastname: Palomino
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D001944:Breath Tests / Q000379:methods; D045853:Exhalation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D018927:Anti-Asthmatic Agents; D009569:Nitric Oxide