Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Annual Fractional Exhaled Nitric Oxide Measurements and Exacerbations in Severe Asthma

Session Title
TP10 - TP010 CLINICAL AND POPULATION-LEVEL STUDIES OF ASTHMA
Abstract
A1432 - Annual Fractional Exhaled Nitric Oxide Measurements and Exacerbations in Severe Asthma
Author Block: Y. Abe, M. Suzuki, H. Kimura, K. Shimizu, H. Makita, M. Nishimura, S. Konno; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
RATIONALE: Fractional exhaled nitric oxide (FeNO) reflects eosinophilic inflammation of the airways. FeNO is associated with the levels of eosinophils in the airway mucosa, bronchoalveolar lavage fluid, sputum, and blood; thus, FeNO levels are high in patients with asthma characterized by type 2 inflammation. However, the significance of longitudinal assessment of FeNO, including its variability, in the clinical course of severe asthma remains unclear. The aim of this study is to examine the association between long-term changes in FeNO and the development of exacerbations in severe asthma, using data from a 3-year prospective observational cohort study.
METHODS: Among the severe asthma patients enrolled in the Hokkaido Severe Asthma Cohort Study (Kimura, Ann Am Thorac Soc 2017, Konno, Ann Am Thorac Soc 2018), 100 patients with severe asthma who completed a 3-year follow-up in which FeNO was measured annually were included. According to the FeNO level at baseline, 1 year, and 2 years, the patients were classified into three groups: the sustained high group (≥50 ppb at all three visits), the sustained low group (<25 ppb at all three visits), and the intermediate group (other). Subjects in the intermediate group were further classified into two groups based on the median value of the coefficient of variation (CV) of FeNO during the 3 years (high CV and low CV intermediate groups).
RESULTS: The sustained high group experienced shorter exacerbation-free survival and more frequent exacerbations than the sustained low group (median number of exacerbation events, 3 vs. 0, p = 0.01). In the intermediate group, the high CV group experienced shorter exacerbation-free survival than the low CV group, and the CV of FeNO was an independent contributing factor for the early onset of the first exacerbation event and frequency of exacerbations on multivariate analysis.
CONCLUSIONS:Persistence of FeNO above 50 ppb over the years as well as the presence of large variations in FeNO levels were associated with the development of exacerbations in patients with severe asthma.