Exhaled nitric oxide in chronic cough: A good tool in a multi-step approach - 22/11/19
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Abstract |
Introduction |
The impact of fractional exhaled nitric oxide (FENO) on the management of chronic cough (CC) is still inconclusive. The aim of the present study was to assess whether FENO is a good tool to predict the response to inhaled corticosteroids (ICS) in patients with CC.
Methods |
Patients, referred for investigation of CC, had a FENO measurement determined as part of their first-line assessment. A methacholine test was performed as part of a second-line assessement. Patients were assigned to two groups according to their FENO values: a high FENO level group (≥25 ppb) and a normal FENO level group (<25 ppb).
Results |
One hundred patients were included in the study. High FENO levels were found in 25 patients (25%). The proportion of patients who responded to ICS was significantly greater in the high FENO group compared to the normal FENO level group (86.4% vs 46.3%, P<0.05). FENO is a good tool to predict ICS response in patients with high FENO levels but a response to ICS cannot be ruled out in patients with normal FENO levels. In patients with normal FENO values, a methacholine test could be an interesting tool for a second-line assessment. Among the 13 patients with a positive methacholine test result, 11 responded to ICS whilst 2 did not. Of the patients with a negative methacholine test result, 3 responded to ICS whilst 13 did not.
Conclusion |
FENO may be a more reliable predictor of ICS response when used as part of a multi-step assessment procedure.
El texto completo de este artículo está disponible en PDF.Keywords : Chronic cough, Exhaled FENO, Eosinophilic bronchitis, Cough-variant asthma
Esquema
Vol 76
P. 4-9 - novembre 2019 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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