Fractional exhaled nitric oxide and asthma treatment adherence.

Abstract:

PURPOSE OF REVIEW:Despite increased clinician awareness, nonadherence to inhaled corticosteroid treatment presents a major challenge to successful asthma management and risks inappropriate treatment escalation, particularly in severe disease. In patients with Type-2 mediated biology, fractional exhaled nitric oxide (FeNO) has a role in assessment and monitoring of adherence to inhaled corticosteroids. RECENT FINDINGS:Asthmatic patients with elevated FeNO are at an increased risk of exacerbation. High FeNO is often secondary to suboptimal adherence to inhaled corticosteroid treatment, whether intentional or nonintentional. FENO-suppression can 'unmask' underlying adherence issues and is a useful test in the presence of Type-2 biology in the 'difficult-to-control' asthma population. Identification of nonadherence can improve asthma control and prevent inappropriate commencement of costly biologic therapies. SUMMARY:Assessment of adherence and FeNO response to monitored inhaled corticosteroid in Type-2 biomarker high asthmatic individuals may prevent unnecessary escalation to biologic therapy. Establishing an 'optimised' FeNO may alert clinicians to the possibility of underlying nonadherence at future clinical assessments.

authors

Butler CA,Heaney LG

doi

10.1097/ACI.0000000000000704

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

59-64

issue

1

eissn

1528-4050

issn

1473-6322

pii

00130832-202102000-00010

journal_volume

21

pub_type

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