The use of exhaled nitric oxide measurements plus standard clinical evaluation for patients with asthma resulted in changes in therapy and reduced costs, according to recent study results.
“Asthma management in an outpatient setting is best accomplished by clinical evaluation coupled with spirometry and symptom evaluation, but these assessments do not provide information about airway inflammation,” researchers wrote. “Exhaled nitric oxide (fraction of exhaled nitric oxide [FeNO]) measures T-helper cell type 2-mediated airway inflammation and may be a useful adjunct in asthma management.”
In an observational, single-visit study, researchers studied 50 patients (mean age, 35.16 years; 60% females) with established asthma in November 2013 at an outpatient asthma and allergy specialty clinic. Clinical examination, spirometry and symptom assessment using the Asthma Control Test were conducted to evaluate patients, with five clinicians estimating airway inflammation. Treatment decisions were based on assessments.
“Without FeNO, the clinicians’ assessment of airway inflammation was incorrectly classified in 50% of subjects,” the researchers wrote.
Treatment decisions were substantially altered in one-third of participants after the FeNO results, including medication added or dose increased in 10 patients, and medication discontinued or dose decreased in eight patients.
Researchers estimated savings of $629 per patient annually when FeNO was used in addition to standard care.