Fractional Exhaled Nitric Oxide Clinical Utility in Asthma Management

Project Summary Title and Description

Title
Fractional Exhaled Nitric Oxide Clinical Utility in Asthma Management
Description
To evaluate the clinical utility and diagnostic accuracy of fractional exhaled nitric oxide (FeNO) in people age 5 years and older with asthma; and the ability of FeNO measured at age 4 years or younger to predict a future diagnosis of asthma. PubMed ID:
Attribution
N/A
Authors of Report
N/A
Methodology description
We searched from databases’ inception to April 2017 for studies enrolling patients with or suspected to have asthma that evaluated the diagnosis or clinical utility of FeNO. We included randomized and nonrandomized comparative studies.
PROSPERO
N/A
DOI
10.26300/0px7-js77
Notes
Attached Files: Baseline and outcomes.pdf: Baseline characteristics for included studies and outcomes Outcomes.pdf: Diagnostic accuracy of FeNO measurement outcomes Quality.pdf: Quality assessment for included studies
Funding Source
AHRQ

Key Questions

1. What is the clinical utility of FeNO measurements in the management of asthma in addition to, or instead of, other tests that might be performed? KQ 1.a: What is the diagnostic accuracy of FeNO measurement(s) for making the diagnosis of asthma in individuals ages 5 and older? KQ 1.b: What is the clinical utility of FeNO measurements in monitoring disease activity and asthma outcomes in individuals with asthma ages 5 and older ? KQ 1.c: What is the clinical utility of FeNO measurements to select medication options (including steroids) for individuals ages 5 and older? KQ 1.d: What is the clinical utility of FeNO measurements to monitor response to treatment in individuals ages 5 and older? KQ 1.e. In children ages 0-4 years with recurrent wheezing, how accurate is FeNO testing in predicting the future development of asthma at age 5 and above?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Exhaled nitric oxide levels in military recruits with new onset asthma.-- Not Found --
Exhaled nitric oxide and asthma in young children.2001
FENO and AHR mannitol in patients referred to an out-of-hospital asthma clinic: a real-life study.2014
Exhaled nitric oxide in the diagnosis of asthma: comparison with bronchial provocation tests.2005
A comparison of exhaled nitric oxide and induced sputum as markers of airway inflammation.2000
Exhaled nitric oxide in a population sample of adults.2008
Utility of nitric oxide for the diagnosis of asthma in an allergy clinic population.-- Not Found --
Exhaled nitric oxide as a diagnostic test for asthma: online versus offline techniques and effect of flow rate.2002
Prospective evaluation of the validity of exhaled nitric oxide for the diagnosis of asthma.2003
Exhaled nitric oxide and screening for occupational asthma in two at-risk sectors: bakery and hairdressing.2014
Diagnostic utility of inflammatory biomarkers in asthma: exhaled nitric oxide and induced sputum eosinophil count.2007
Validation study of asthma screening criteria based on subjective symptoms and fractional exhaled nitric oxide.2011
Diagnostic value of lung function parameters and FeNO for asthma in schoolchildren in large, real-life population.
Exhaled nitric oxide as a diagnostic test for asthma in rhinitic patients with asthmatic symptoms.2006
Combined use of exhaled nitric oxide and airway hyperresponsiveness in characterizing asthma in a large population survey.2000
Prevalence of asthma symptoms based on the European Community Respiratory Health Survey questionnaire and FENO in university students: gender differences in symptoms and FENO.2011
Predictive value of fractional nitric oxide in asthma diagnosis-subgroup analyses.2014
Exhaled nitric oxide as screening tool in subjects with suspected asthma without reversibility.2013
Portable exhaled nitric oxide as a screening tool for asthma in young adults during pollen season.2008
Investigation of occupational asthma: sputum cell counts or exhaled nitric oxide?2010
The value of exhaled nitric oxide to identify asthma in smoking patients with asthma-like symptoms.2012
The utility of exhaled nitric oxide in patients with suspected asthma.2016
Exhaled nitric oxide cutoff values for asthma diagnosis according to rhinitis and smoking status in Japanese subjects.2011
Portable exhaled nitric oxide measurement: Comparison with the "gold standard" technique.2007
Diagnostic tests for asthma in firefighters.2007
Asthma tests in the assessment of military conscripts.2010
Comparison of eNO and histamine hyperresponsiveness in diagnosing asthma in new referrals.2010
Usefulness of exhaled nitric oxide for diagnosing asthma.2010
Diagnostic value of exhaled nitric oxide measurement in mild asthma.2011
The value of exhaled nitric oxide in predicting bronchial hyperresponsiveness in children.2008
Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.2010
Clinical usefulness of fractional exhaled nitric oxide for diagnosing prolonged cough.
Is FENO50 useful diagnostic tool in suspected asthma?2012
FENO measurement and sputum analysis for diagnosing asthma in clinical practice.2013
Prognostic value of bronchial provocation and FENO measurement for asthma diagnosis--results of a delayed type of diagnostic study.2014
Diagnosing asthma in general practice with portable exhaled nitric oxide measurement--results of a prospective diagnostic study: FENO < or = 16 ppb better than FENO < or =12 ppb to rule out mild and moderate to severe asthma added.
The use of exhaled nitric oxide in the diagnosis of asthma in school children.2009
Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests.2004
The relationship of exhaled nitric oxide to airway inflammation and responsiveness in children.2005
Reference ranges for exhaled nitric oxide derived from a random community survey of adults.
Utility of fractional exhaled nitric oxide (F(E)NO) measurements in diagnosing asthma.2012
Exhaled nitric oxide discriminates children with and without allergic sensitization in a population-based study.2011
Predictive value of lung function trend and FeNO for difficult asthma in children.2012
Cost-effectiveness of FENO-based and web-based monitoring in paediatric asthma management: a randomised controlled trial.2016
Economic evaluation of FE(NO) measurement in diagnosis and 1-year management of asthma in Germany.2008
Is exhaled nitric oxide a useful adjunctive test for assessing asthma?2009
High exhaled nitric oxide levels may predict bronchial reversibility in allergic children with asthma or rhinitis.2013
Offline exhaled nitric oxide in emergency department and subsequent acute asthma control.2008
Exhaled nitric oxide in the management of childhood asthma: a prospective 6-months study.2006
Role of spirometry and exhaled nitric oxide to predict exacerbations in treated asthmatics.2006
Exhaled nitric oxide levels during acute asthma exacerbation.2005
Asthma severity, recommended changes of inhaled therapy and exhaled nitric oxide in children: a prospective, blinded trial.2000
The use of exhaled nitric oxide monitoring in primary care asthma clinics: a pilot study.2007
Relationship of the Arabic version of the asthma control test with ventilatory function tests and levels of exhaled nitric oxide in adult asthmatics.2014
Office-based exhaled nitric oxide measurement in children 4 years of age and older.
Exhaled nitric oxide predicts asthma exacerbation.2004
Stratifying a risk for an increased variation of airway caliber among the clinically stable asthma.2013
Usefulness of offline fractional exhaled nitric oxide measurements in the elderly asthmatic patients.-- Not Found --
Fractional exhaled nitric oxide is a useful adjunctive modality for monitoring bronchial asthma.-- Not Found --
Evaluation of the asthma control test: a reliable determinant of disease stability and a predictor of future exacerbations.2012
Exhaled NO and exhaled breath condensate pH in the evaluation of asthma control.2011
The role of exhaled nitric oxide in evaluation of acute asthma in a pediatric emergency department.2009
Assessment of asthma control: clinical, functional and inflammatory aspects.2013
Value of surrogate tests to predict exercise-induced bronchoconstriction in atopic childhood asthma.2007
Multicentre trial evaluating alveolar NO fraction as a marker of asthma control and severity.2010
The clinical use of exhaled nitric oxide in wheezing children.-- Not Found --
Guideline-recommended fractional exhaled nitric oxide is a poor predictor of health-care use among inner-city children and adolescents receiving usual asthma care.2013
Symptoms, spirometry, exhaled nitric oxide, and asthma exacerbations in clinical practice.2008
Exhaled nitric oxide corresponds with office evaluation of asthma control.2003
Exhaled nitric oxide and asthma control: a longitudinal study in unselected patients.2008
Exhaled nitric oxide as a marker of asthma control in smoking patients.2009
Fractioned exhaled nitric oxide (FE(NO)) is not a sufficiently reliable test for monitoring asthma in pregnancy.2013
Control maintenance can be predicted by exhaled NO monitoring in asthmatic patients.2011
Asthma control test is correlated to FEV1 and nitric oxide in Greek asthmatic patients: influence of treatment.2011
Exhaled nitric oxide fraction as an add-on to ACQ-7 for not well controlled asthma detection.2013
Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice.2009
Fractional exhaled nitric oxide in children with acute exacerbation of asthma.2014
Exhaled nitric oxide in relation to asthma control: A real-life survey.-- Not Found --
Exhaled nitric oxide and biomarkers in exhaled breath condensate indicate the presence, severity and control of childhood asthma.2007
Childhood asthma: exhaled markers of airway inflammation, asthma control score, and lung function tests.2004
The strategy for predicting future exacerbation of asthma using a combination of the Asthma Control Test and lung function test.2009
Relationship of the asthma control test with pulmonary function and exhaled nitric oxide.2008
Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial.2008
Daily exhaled nitric oxide measurements and asthma exacerbations in children.2012
Prediction of asthma exacerbations in children by innovative exhaled inflammatory markers: results of a longitudinal study.2015
Is fractional exhaled nitric oxide (FeNO) associated with asthma control in children?2014
Association between levels of fractional exhaled nitric oxide and asthma exacerbations in Thai children.2017
Monitoring strategies in children with asthma: a randomised controlled trial.2015
Exhaled nitric oxide in relation to the clinical features of childhood asthma.2004
Association of longitudinal fractional exhaled nitric oxide measurements with asthma control in atopic children.2015
Identifying uncontrolled asthma in children with the childhood asthma control test or exhaled nitric oxide measurement.2012
Response profiles to fluticasone and montelukast in mild-to-moderate persistent childhood asthma.2006
Association of exhaled nitric oxide to asthma burden in asthmatics on inhaled corticosteroids.2011
Changes of exhaled nitric oxide during steroid treatment of childhood asthma.2002
Exhaled NO is a poor marker of asthma control in children with a reported use of asthma medication: a pharmacy-based study.2012
Comparison of physician-, biomarker-, and symptom-based strategies for adjustment of inhaled corticosteroid therapy in adults with asthma: the BASALT randomized controlled trial.
Daily telemonitoring of exhaled nitric oxide and symptoms in the treatment of childhood asthma.2009
Internet-based tapering of oral corticosteroids in severe asthma: a pragmatic randomised controlled trial.2011
Symptom- and fraction of exhaled nitric oxide-driven strategies for asthma control: A cluster-randomized trial in primary care.2015
The Combined Impact of Exhaled Nitric Oxide and Sputum Eosinophils Monitoring in Asthma Treatment: A Prospective Cohort Study.2015
Exhaled nitric oxide in childhood allergic asthma management: a randomised controlled trial.2014
Management based on exhaled nitric oxide levels adjusted for atopy reduces asthma exacerbations in children: A dual centre randomized controlled trial.2015
Titrating steroids on exhaled nitric oxide in children with asthma: a randomized controlled trial.2005
Exhaled nitric oxide monitoring does not reduce exacerbation frequency or inhaled corticosteroid dose in paediatric asthma: a randomised controlled trial.2013
Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial.2011
The use of exhaled nitric oxide to guide asthma management: a randomized controlled trial.2007
Use of exhaled nitric oxide measurements to guide treatment in chronic asthma.2005
Anti-inflammatory treatment of atopic asthma guided by exhaled nitric oxide: a randomized, controlled trial.-- Not Found --
FeNO as a Marker of Airways Inflammation: The Possible Implications in Childhood Asthma Management.2010
Impact of exhaled nitric oxide measurements on treatment decisions in an asthma specialty clinic.2014
Usefulness of exhaled nitric oxide and sputum eosinophils in the long-term control of eosinophilic asthma.
Asthma diagnosis and severity monitoring in primary school children: essential role of sequential testing of exhaled nitric oxide.-- Not Found --
Inflammatory markers as exacerbation risk factors after asthma therapy switch from inhaled steroids to montelukast.2016
Biomarker-based asthma phenotypes of corticosteroid response.2015
Exhaled nitric oxide and clinical phenotypes of childhood asthma.
Exhaled nitric oxide: a predictor of steroid response.2005
NO in exhaled air of asthmatic children is reduced by the leukotriene receptor antagonist montelukast.1999
Exhaled nitric oxide before and after montelukast sodium therapy in school-age children with chronic asthma: a preliminary study.1999
Effects of montelukast treatment and withdrawal on fractional exhaled nitric oxide and lung function in children with asthma.
Effect of montelukast on exhaled nitric oxide and nonvolatile markers of inflammation in mild asthma.
Exhaled nitric oxide in children with asthma receiving Xolair (omalizumab), a monoclonal anti-immunoglobulin E antibody.2004
Comprehensive efficacy of omalizumab for severe refractory asthma: a time-series observational study.2014
Corticosteroids decrease exhaled nitric oxide in children with acute asthma.1997
The effect of beclometasone dipropionate/formoterol extra-fine fixed combination on the peripheral airway inflammation in controlled asthma.2015
Exhaled nitric oxide measurements in normal and asthmatic children.1997
Exhaled nitric oxide correlates with airway hyperresponsiveness in steroid-naive patients with mild asthma.1998
Effect of fluticasone on markers of inflammation and quality of life in steroid-naive patients with mild asthma.2010
Rapid effect of inhaled ciclesonide in asthma: a randomized, placebo-controlled study.2008
Effect of fluticasone 250 microg/salmeterol 50 microg and montelukast on exhaled nitric oxide in asthmatic patients.-- Not Found --
Comparison of the effects of budesonide/formoterol maintenance and reliever therapy with fluticasone/salmeterol fixed-dose treatment on airway inflammation and small airway impairment in patients who need to step-up from inhaled corticosteroid monotherapy.
The effect of airway remodelling on airway hyper-responsiveness in asthma.2011
Inhaled glucocorticoids decrease nitric oxide in exhaled air of asthmatic patients.1996
Dose-dependent onset and cessation of action of inhaled budesonide on exhaled nitric oxide and symptoms in mild asthma.2002
Effect of once-daily generic ciclesonide on exhaled nitric oxide in atopic children with persistent asthma.-- Not Found --
Dose-dependent anti-inflammatory effect of inhaled mometasone furoate/formoterol in subjects with asthma.2013
Association of symptom control with changes in lung function, bronchial hyperresponsiveness, and exhaled nitric oxide after inhaled corticosteroid treatment in children with asthma.2016
Effect of nebulized beclomethasone on airway inflammation and clinical status of children with allergic asthma and rhinitis: a randomized, double-blind, placebo-controlled study.2013
Dose-response relationship and reproducibility of the fall in exhaled nitric oxide after inhaled beclomethasone dipropionate therapy in asthma patients.2001
Association between fraction of exhaled nitrous oxide, bronchodilator response and inhaled corticosteroid type.-- Not Found --
Time-dependent changes in orally exhaled nitric oxide and pulmonary functions induced by inhaled corticosteroids in childhood asthma.2001
Concordance between bronchial hyperresponsiveness, fractional exhaled nitric oxide, and asthma control in children.2016
Comparison of add-on therapy to inhaled fluticasone propionate in children with asthma: residual volume and exhaled nitric oxide as outcome measures.-- Not Found --
Effect of salmeterol treatment on nitric oxide level in exhaled air and dose-response to terbutaline in children with mild asthma.1998
A 12-week, randomized, parallel-group, proof-of-concept study of tulobuterol patch and salmeterol inhaler as add-on therapy in adult-onset mild-to-moderate asthma.2017
Effects of the addition of tiotropium on airway dimensions in symptomatic asthma.2016
Exhaled nitric oxide as a predictor of exacerbation in children with moderate-to-severe asthma: a prospective, 5-month study.2009
Asthma control can be maintained after fixed-dose, budesonide/ formoterol combination inhaler therapy is stepped down from medium to low dose.2013
The predictive value of exhaled nitric oxide measurements in assessing changes in asthma control.2001
Changes in exhaled nitric oxide and breath pH during fluticasone wean in asthma.2010
Step-down of budesonide/formoterol in early stages of asthma treatment leads to insufficient anti-inflammatory effect.
Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission.2005
Airway responsiveness to adenosine 5'-monophosphate and exhaled nitric oxide measurements: predictive value as markers for reducing the dose of inhaled corticosteroids in asthmatic subjects.2003
Markers for step-down of inhaled corticosteroid therapy in adult asthmatics.2012
Application of non-invasive biomarkers in a birth cohort follow-up in relation to respiratory health outcome.2010
Young infants with recurrent wheezing and positive asthma predictive index have higher levels of exhaled nitric oxide.
Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE.2010
Exhaled nitric oxide during infancy as a risk factor for asthma and airway hyperreactivity.2015
Exhaled nitric oxide predicts persistence of wheezing, exacerbations, and decline in lung function in wheezy infants and toddlers.2013
Fraction of exhaled nitric oxide and asthma predictive index in infants less than two years-old.2011
Prediction and treatment of asthma in preschool children at risk: study design and baseline data of a prospective cohort study in general practice (ARCADE).2009
Usefulness of exhaled nitric oxide (FeNO) measured by a portable analyzer to diagnose cough variant asthma in a clinical setting of chronic cough2009
A study of fraction of exhaled nitric oxide levels as a diagnostic marker in patients with bronchial asthma2013
Does asthma control as assessed by the asthma control test reflect airway inflammation? 2011
Clinical correlates and determinants of airway inflammation in pediatric asthma2010
Exhaled nitric oxide measures allergy not symptoms in children with allergic rhinitis in primary care: A prospective cross-sectional and longitudinal cohort study2013
Fractional exhaled nitric oxide levels as a predictor of long-term prognoses in patients with mild asthma2016
Long-Term Adjustment of Stable Asthma Treatment with Fractional Exhaled Nitric Oxide and Sputum Eosinophils2012
Additional effects of pranlukast on exhaled nitric oxide levels in patients with persistent asthma2009
Effect of short- and long-acting inhaled beta2-agonists on exhaled nitric oxide in asthmatic patients1997
Association between the asthma predictive index and levels of exhaled nitric oxide in infants and toddlers with recurrent wheezing2013
Symptoms, but not a biomarker response to inhaled corticosteroids, predict asthma in preschool children with recurrent wheeze2012

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