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Baseline FeNO as a prognostic biomarker for subsequent severe asthma exacerbations in patients with uncontrolled, moderate-to-severe asthma receiving placebo in the LIBERTY ASTHMA QUEST study: a post-hoc analysis
- Source :
- The Lancet Respiratory Medicine. 9:1165-1173
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Fractional exhaled nitric oxide (FeNO) has potential as a prognostic biomarker in asthma, but its prognostic value among other recognised indicators is unclear. We assessed the added prognostic value of baseline FeNO to blood eosinophil count and prior severe asthma exacerbations for subsequent exacerbations.In this post-hoc analysis of the 52-week, double-blind, phase 3 LIBERTY ASTHMA QUEST study, we identified 620 patients with moderate-to-severe asthma who were randomly assigned to placebo; had uncontrolled asthma with inhaled glucocorticoids plus up to two controllers; one or more exacerbations in the previous year; FEVPatients with baseline FeNO of 50 ppb or higher (n=144) had a 1·54-times higher exacerbation rate than patients with FeNO of less than 25 ppb (n=291; relative risk 1·54 [95% CI 1·11-2·14]; p=0·0097). Patients with baseline FeNO of 25 to50 ppb (n=185) had a 1·33-times higher exacerbation rate than patients with FeNO of less than 25 ppb (1·33 [0·99-1·78]; p=0·0572). Patients with baseline FeNO of 25 ppb or higher, a blood eosinophil count of 150 cells per μL or higher, and two or more prior exacerbations (n=157) had an exacerbation rate 3·62-times higher than patients with FeNO of less than 25 ppb, a blood eosinophil count of less than 150 cells per μL, and one prior exacerbation (n=116; 3·62 [1·67-7·81]; p=0·0011).In uncontrolled, moderate-to-severe asthma, higher baseline FeNO levels were associated with greater risk of severe asthma exacerbations, particularly in combination with elevated eosinophil count and prior exacerbations, supporting the added value of FeNO as a prognostic biomarker. Further research is needed to confirm FeNO as an independent predictor for asthma exacerbations.Sanofi and Regeneron Pharmaceuticals.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Exacerbation
business.industry
respiratory system
Eosinophil
Prognosis
Placebo
medicine.disease
Asthma
respiratory tract diseases
Eosinophils
medicine.anatomical_structure
Double-Blind Method
Asthma Control Questionnaire
Internal medicine
Relative risk
Post-hoc analysis
Exhaled nitric oxide
medicine
Humans
Anti-Asthmatic Agents
business
Subjects
Details
- ISSN :
- 22132600
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- The Lancet Respiratory Medicine
- Accession number :
- edsair.doi.dedup.....2b604cbcfdef824eadd84f60f665aeba