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dc.contributor.authorTurner, Stephen
dc.contributor.authorFielding, Shona
dc.contributor.authorPijnenburg, Marielle
dc.contributor.authorDe Jongste, Johan
dc.contributor.authorPike, Katy
dc.contributor.authorRoberts, Graham
dc.contributor.authorPetsky, Helen
dc.contributor.authorChang, Anne
dc.contributor.authorFritsch, Maria
dc.contributor.authorFrischer, Thomas
dc.contributor.authorSzefler, Stan
dc.contributor.authorGergen, Peter
dc.contributor.authorVermeulen, Francoise
dc.contributor.authorVael, Robin
dc.description.abstractIntroduction: Guidelines recommend spirometry and/or fractional exhaled nitric oxide (FeNO) as objective measurements to guide asthma management. Our hypothesis was that falling FEV1, FEV1/FVC ratio or FEF25-75 or rising FeNO measurements are associated with future adverse asthma outcomes. Methods: Data were obtained from 7 trials using FeNO to guide asthma treatment. Predictors were change in % FEV1, FEV1/FVC ratio or FEF25-75 and % change in FeNO between baseline and 3 months. Loss of asthma control and asthma attack between 3 and 6 months were the outcomes. A one-stage individual patient data meta-analysis was conducted using a mixed effects logistic model, including a random effect for study. Results: Data were available in 1112 children (58% male, mean age 12.6 years [SD 3.1]) from seven trials. A reduction of 10% FEV1 was associated with increased risk for future attack (OR 1.28 [1.02, 1.58]) and for loss of control (OR 1.21 [1, 1.45]), and a reduction of 10% FVC with increased risk for future attack (OR 1.40 [1.04, 1.88]). Changes in %FEF25-75 and %FEV1/FVC ratio were not linked to future outcomes. Each 20% increase in FeNO was associated with increased risk for future loss of control (OR 1.041 [1.000, 1.062]). Baseline %FEV1/FVC was associated with increased risk for attack over the next three months (OR per % predicted reduction 1.037 [1.007, 1.067]). Otherwise no measurement at baseline was associated with later outcome. Conclusions: Change in %FEV1 over a three month period may be useful as part of dynamic risk assessment. Whether a large change in FeNO may also be useful for dynamic risk assessment remains uncertain.en_US
dc.publisherEuropean Respiratory Societyen_US
dc.relation.ispartofconferencename28th International Congress of the European-Respiratory-Society (ERS)en_US
dc.relation.ispartofconferencetitleEuropean Respiratory Journalen_US
dc.relation.ispartoflocationParis, Franceen_US
dc.subject.fieldofresearchMedical and Health Sciencesen_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsRespiratory Systemen_US
dc.titleDo changes in spirometric indices and FeNO predict asthma outcomes in children? An individual patient data analysis using results from seven FeNO trialsen_US
dc.typeConference outputen_US
dc.type.descriptionE3 - Conferences (Extract Paper)en_US
dcterms.bibliographicCitationTurner, S; Fielding, S; Pijnenburg, M; De Jongste, J; Pike, K; Roberts, G; Petsky, H; Chang, A; Fritsch, M; Frischer, T; Szefler, S; Gergen, P; Vermeulen, F; Vael, R, Do changes in spirometric indices and FeNO predict asthma outcomes in children? An individual patient data analysis using results from seven FeNO trials, European Respiratory Journal, 2018, 52, pp. PA5011en_US
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gro.griffith.authorPetsky, Helen

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