SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

December 26, 2007

Utility of exhaled nitric oxide in asthma

Summary
The determination of exhaled nitric oxide has been proposed as a management tool to guide asthma therapy. Studies in the past have shown that the use of exhaled nitric oxide is an effective way to determine the lowest dose of inhaled corticosteroid needed for treatment, and to improve outcomes (N Engl J Med 2005; 352:2163-2173).

With less expensive technology to measure exhaled nitric oxide now available, it has been widely anticipated that the use of such measurements in the clinic is on the horizon. However, this study fails to confirm the utility of nitric oxide measurements in the care of asthmatics.

This was a single-blind trial of 118 adult asthmatics. Use of corticosteroids were based on exhaled nitric oxide measurements in one group, and on asthma guidelines (British Thoracic Society) in another. The study was one year in duration.

Exhaled nitric oxide measurements failed to reduce the risk of exacerbations or cumulative corticosteroid dosage.

Reference
Shaw DE, et al. The use of exhaled nitric oxide to guide asthma management: a randomized controlled trial. American Journal of Respiratory and Critical Care Medicine 2007; 176:231-237.

 

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