Abstract
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.
Conclusion: Compared with conventional strategy, longitudinal monitoring of FENO and sputum eosinophils improves eosinophilic asthma control in terms of reduced symptoms and exacerbations without additional increase e in ICS treatment.
Keywords: Asthma, asthma exacerbation rate, asthma symptom score, fraction of exhaled nitric oxide, sputum eosinophils.
Current Pharmaceutical Design
Title:The Combined Impact of Exhaled Nitric Oxide and Sputum Eosinophils Monitoring in Asthma Treatment: A Prospective Cohort Study
Volume: 21 Issue: 32
Author(s): Mario Malerba, Alessandro Radaeli, Alessia Olivini, Beatrice Ragnoli, Fabio Ricciardolo and Paolo Montuschi
Affiliation:
Keywords: Asthma, asthma exacerbation rate, asthma symptom score, fraction of exhaled nitric oxide, sputum eosinophils.
Abstract: 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.
Conclusion: Compared with conventional strategy, longitudinal monitoring of FENO and sputum eosinophils improves eosinophilic asthma control in terms of reduced symptoms and exacerbations without additional increase e in ICS treatment.
Export Options
About this article
Cite this article as:
Malerba Mario, Radaeli Alessandro, Olivini Alessia, Ragnoli Beatrice, Ricciardolo Fabio and Montuschi Paolo, The Combined Impact of Exhaled Nitric Oxide and Sputum Eosinophils Monitoring in Asthma Treatment: A Prospective Cohort Study, Current Pharmaceutical Design 2015; 21 (32) . https://dx.doi.org/10.2174/1871524915666150710123415
DOI https://dx.doi.org/10.2174/1871524915666150710123415 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Opioids and Mechanical Ventilation
Current Drug Targets Extracts of Bacopa monnieri (L) Pennell Down-Regulate the Expression of Leukotriene C<sub>4</sub> Synthase mRNA in HL-60 Cells and Suppress OVAInduced Inflammation in BALB/c Mice
Current Bioactive Compounds Editorial [Hot Topic: Essential Fatty Acids (Guest Editor: Undurti N. Das)]
Current Pharmaceutical Biotechnology The Roles of Vitamin D and Its Analogs in Inflammatory Diseases
Current Topics in Medicinal Chemistry Metal Allergens of Growing Significance: Epidemiology, Immunotoxicology, Strategies for Testing and Prevention
Inflammation & Allergy - Drug Targets (Discontinued) Antioxidant Properties of Kalanchoe blossfeldiana – A Focus on Erythrocyte Membrane Stability and Cytoprotection
Current Traditional Medicine Subject Index
Current Drug Targets - Inflammation & Allergy Immune Frailty and Nanomaterials: The Case of Allergies
Current Bionanotechnology (Discontinued) Adenosine Deaminase in the Modulation of Immune System and its Potential as a Novel Target for Treatment of Inflammatory Disorders
Current Drug Targets Pulmonary Disease in Beta-Thalassemia
Current Respiratory Medicine Reviews Homogeneous Time Resolved Fluorescence Assay to Measure Histamine Release
Combinatorial Chemistry & High Throughput Screening Human Cognitive and Neuro-Psychiatric Bio-Markers in the Cardiac Peri-Operative Patient
Current Molecular Medicine Small Interfering RNA for Effective Cancer Therapies
Mini-Reviews in Medicinal Chemistry Genetics of Cholesterol and Lipoprotein Metabolism
Recent Patents on Cardiovascular Drug Discovery CD38 as a Regulator of Cellular NAD: A Novel Potential Pharmacological Target for Metabolic Conditions
Current Pharmaceutical Design Pharmacogenomics
Current Drug Metabolism Depression in Sleep Related Breathing Disorder
Current Respiratory Medicine Reviews Perioperative Considerations of Herbal Medications
Current Clinical Pharmacology Chitinases: Therapeutic Scaffolds for Allergy and Inflammation
Recent Patents on Inflammation & Allergy Drug Discovery Identification and Treatment of Patients with Early COPD
Current Respiratory Medicine Reviews