Extra Test Doesn't Help Kids with Asthma
Posted on: Monday, 12 January 2009, 09:37 CST
Adding an expensive test to standard symptom monitoring doesn't appear to help children with mild to moderate asthma.
In a new study out of the Netherlands, researchers saw equally significant improvements for children whose asthma medications were adjusted based on symptoms alone as for those whose medications were adjusted based on symptoms plus daily measurement of the fractional exhaled nitric oxide, or FENO. FENO measurements can help predict worsening asthma symptoms. Many doctors believed these measurements, with subsequent adjustments in medication, could improve asthma control.
The research involved 151 children from 15 centers who were randomly assigned to either the symptom only or symptom plus FENO group. At the end of the 30-week study both groups were enjoying better symptom control and had also been able to reduce their inhaled steroid doses by about 50 percent.
"We speculate that daily supervision and frequent phone contacts have produced an improvement that could not be beaten by additional monitoring of FENO," study author Johan C. de Jongste, M.D., Ph.D., from Erasmus University Medical Center-Sophia Children's Hospital, was quoted as saying.
Is there no role for FENO measurements in the treatment of asthma? These investigators and others who wrote editorials on the study believe the test may still have some use, particularly in severe asthma. They call for additional studies to address these patients.
SOURCE: American Journal of Respiratory and Critical Care Medicine, published online January 7, 2009
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American Journal of Respiratory and Critical Care Medicine
Source: Ivanhoe
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