Use of Exhaled Nitric Oxide Measurements to Guide Treatment in Chronic Asthma

The proper management of asthma with the use of inhaled corticosteroids requires the adjustment of doses in proportion to the patient's need for treatment. In this study, the investigators compared groups treated according to two regimens, one based on conventional guidelines for the treatment of asthma and one based on measurements of the fraction of nitric oxide in the exhaled air. In the latter group, equivalent control of asthma was maintained with lower doses of inhaled corticosteroids. The investigators compared groups treated according to two regimens, one based on conventional guidelines for the treatment of asthma and one based on measurements of the fraction of nitric oxide in the exhaled air. Inhaled corticosteroids are the mainstay of treatment for chronic asthma, the doses of which should be adequate to control asthma symptoms but also as low as possible in order to prevent adverse effects. Since the dose required is highly variable, both among patients and within individual patients, physicians need an easy, effective, and safe method to guide dose titration. Current treatment guidelines recommend that adjustments in doses should be based on asthma symptoms and the results of basic pulmonary-function tests. Two proof-of-concept studies have demonstrated that the use of alternative criteria — namely, airway hyperresponsiveness 1 or eosinophilia in induced sputum . . .