Scottish consensus statement on the role of FeNO in adult asthma

Kuo, Chris RuiWen; Spears, Mark; Haughney, John; Smith, Andrew D.; Miller, Joy; Bradshaw, Tracey; Murray, Lorna; Williamson, Peter; Lipworth, Brian J.

doi:10.1016/j.rmed.2019.07.010

Cited by 42 publications

(27 citation statements)

References 35 publications

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“…50 Nevertheless, we feel that these cutpoints should be lower in patients taking ICS, for instance using FeNO ≥25 ppb. 51 Caution should also be exercised when interpreting FeNO levels in the presence of comorbidities. For example, one prospective study of severe asthmatics confirmed elevated FeNO and PBE values in patients with nasal polyposis compared to to those without.…”

Section: Further Clinical Considerationsmentioning

confidence: 99%

Pragmatic Clinical Perspective on Biologics for Severe Refractory Type 2 Asthma

Chan

Kuo

Lipworth

2020

The Journal of Allergy and Clinical Immunology: In Practice

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Section: Further Clinical Considerationsmentioning

confidence: 99%

Pragmatic Clinical Perspective on Biologics for Severe Refractory Type 2 Asthma

Chan

Kuo

Lipworth

2020

The Journal of Allergy and Clinical Immunology: In Practice

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“…[31,32] Therefore, many guidelines recommend that FeNO should be combined with other objective evidence to identify in ammatory respiratory diseases. [1,26,29,33] B-Eos count, another promising and easy-to-measure biomarker, is more attractive as a means of diagnosing asthma. [6,34] In this study, we found that the optimal diagnostic cutoff level was 203 cells/µl for B-Eos to identify asthma.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of the combination of exhaled nitric oxide and blood eosinophil count in the diagnosis of asthma in China

Li¹,

Han²,

Wang³

et al. 2020

Preprint

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BackgroundTests to identify reversible airflow limitation are important in asthma diagnosis, but they are time-consuming and may be difficult for patients to cooperate. We aim to evaluate the predictive value of fractional exhaled nitric oxide (FeNO) and blood eosinophil (B-Eos) count in asthma diagnosis, and to distinguish patients who could avoid reversibility testing.MethodsWe screened 7463 suspected asthma cases between January 2014 and December 2019 in Chongqing, China, and identified 2349 patients with complete FeNO, B-Eos count, and spirometry data. Of these, 824 were diagnosed with asthma via a positive bronchial-provocation or bronchodilation test.ResultsWhen FeNO and B-Eos counts were used in combination, the area under the receiver operating characteristic curve (AUC) for diagnosing asthma increased (0.768 vs. 0.745 or 0.728; both P < 0.001). The odds ratio for having asthma increased progressively with a gradual increase in FeNO or B-Eos count (both P < 0.001). Further analysis of in-series combinations of different threshold values for these biomarkers indicated that moderately elevated biomarker levels (FeNO > 40 ppb and B-Eos > 300 cells/μl) support a diagnosis of asthma because diagnostic specificity was > 95% and the positive likelihood ratio (PLR) was > 10. This conclusion was verified when selecting the data from 2017 to 2019 as the verification cohort.ConclusionThe combination of FeNO and B-Eos count can improve diagnostic efficacy for asthma. Patients with moderately elevated biomarkers (FeNO > 40 ppb and B-Eos > 300 cells/μl) could be diagnosed with asthma.

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“…Justifi cación: La disminución de la FeNO es dependiente de la dosis del esteroide, tanto por vía inhalada como oral. 68 La reducción de la FeNO es más rápida en no adherentes después de siete días de buena adherencia; 69 los niveles bajos de la FeNO podrían indicar buena adherencia al tratamiento, pero también pueden ser el resultado de una mejoría en el apego por una exacerbación reciente. La presencia de niveles elevados (intermedios o altos) de la FeNO en pacientes que permanecen sintomáticos a pesar de la terapia de mantenimiento con CEI, indica un control subóptimo.…”

Section: Consenso Método Delphiunclassified

“…traron que valores de la FeNO > 40.3 ppb identifi caron a los pacientes con declinación rápida del VEF 1 (sensibilidad 43 %, especifi cidad 86 %); por otra parte, aquellos con FeNO alta de forma persistente tuvieron tasas más elevadas de disminución de la FeNO que aquellos con valores más bajos (p < 0.0005). 46 FeNO en la clínica del asma: sugerencias prácticas para su uso Existen condiciones que pueden infl uir en los valores de la FeNO; 17,69,71,72,73,74,75 algunas de ellas son controversiales, por lo que deben registrarse al momento de la medición, como la edad, 76 el sexo biológico, 71 la talla (la FeNO aumenta con la estatura), 71 el ciclo menstrual, el ciclo circadiano. 77 La FeNO es más alto en hombres, con progesterona elevada y temprano por la mañana en niños, 78 aunque en adultos no parece haber diferencias signifi cativas.…”

Section: Consenso Método Delphiunclassified

Consenso mexicano en relación con la fracción exhalada de óxido nítrico (FeNO) en asma 2020

Larenas‐Linnemann¹,

Gochicoa‐Rangel²,

Macías-Weinmann³

et al. 2020

RAM

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La fracción exhalada de óxido nítrico (FeNO) se relaciona con el nivel de inflamación eosinofílica en las vías aéreas y los niveles de interleucina-13, por lo que podría ser una herramienta diagnóstica y de seguimiento en el asma. Se convocó un grupo de trabajo integrado por neumólogos, expertos en fisiología de la respiración y alergólogos, con la finalidad de establecer criterios para el uso de la FeNO en asma en México. Mediante un método Delphi simplificado y discusión grupal, se consensaron varios puntos clave en relación con el uso de la FeNO. Sugerimos que la medición de la FeNO sirve para el diagnóstico de asma en clínicas especializadas, tanto en niños como adultos, así como para determinar el nivel de tratamiento con corticosteroides. En asma grave, recomendamos la FeNO para la endotipificación, detectar la mala adherencia terapéutica, el subtratamiento y el riesgo de crisis. Sugerimos su uso para determinar el nivel de tratamiento con corticosteroides e identificar pacientes con riesgo de tener una pérdida de la función pulmonar. También la recomendamos en el adulto para mejorar la elección de medicamentos biológicos y, en este contexto, solo la sugerimos en casos selectos en niños.

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Scottish consensus statement on the role of FeNO in adult asthma

Abstract: Circassia Ltd (Oxford, UK) provided an unrestricted educational grant to support the meeting in Perth on 9 th October 2018 which formed the basis of this manuscript. Circassia was not present at the meeting and had no input into the preparation of the manuscript.

Cited by 42 publications

References 35 publications

Pragmatic Clinical Perspective on Biologics for Severe Refractory Type 2 Asthma

Pragmatic Clinical Perspective on Biologics for Severe Refractory Type 2 Asthma

The efficacy of the combination of exhaled nitric oxide and blood eosinophil count in the diagnosis of asthma in China

Consenso mexicano en relación con la fracción exhalada de óxido nítrico (FeNO) en asma 2020

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