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Change in FEV1 and Feno measurements as predictors of future asthma outcomes in children

Chest Dec 18, 2018

Fielding S, et al. - Whether reducing spirometric indices or increasing fractional exhaled nitric oxide (Feno) can predict poor future asthma outcomes in children, was investigated in a one-stage individual patient data meta-analysis by analyzing data from seven randomized controlled trials in which Feno was used to guide asthma treatment; spirometric indices were also measured. Data from 1,112 children (mean age, 12.6 years; mean %FEV1, 94%) were analyzed. In association with a 10% reduction in %FEV1 between baseline and 3 months, 28% increased odds for asthma exacerbation and 21% increased odds for having poor asthma control 6 months after baseline were observed. Findings suggest the contribution of repeated measurements of %FEV1 (that are typically within the “normal” range) to clinical risk assessment of future asthma outcomes in children. A less certain role of repeated Feno measurements was suggested as large changes were related to small changes in outcome risk.
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