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ABSTRACT: Background
Blood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO) concentration are established biomarkers in asthma, associated particularly with the risk of exacerbations. We evaluated the relationship of BEC and FeNO as complementary and independent biomarkers of severe asthma exacerbations.Methods
This observational study included data from the Optimum Patient Care Research Database. Asthma patients (18-80 years) with valid continuous data for 1 year before FeNO reading,???1 inhaled corticosteroid prescription, and BEC recorded???5 years before FeNO reading were separated into cohorts. Categorisation 1 was based on the American Thoracic Society criteria for elevated FeNO concentration (high:???50 ppb; non-high:?9 cells/L; non-high:?9 cells/L). Categorisation 2 (FeNO concentration, high:???35 ppb; non-high:?ResultsIn categorisation 1, patients with either high FeNO or high BEC (n?=?200) had a numerically greater exacerbation rate (unadjusted rate ratio, 1.31 [95% confidence interval: 0.97, 1.76]) compared with patients in the reference group. Combination of high FeNO and high BEC (n?=?27) resulted in a significantly greater exacerbation rate (3.67 [1.49, 9.04]). Similarly, for categorisation 2, when both biomarkers were raised (n?=?53), a significantly greater exacerbation rate was observed (1.72 [1.00, 2.93]).Conclusion
The combination of high FeNO and high BEC was associated with significantly increased severe exacerbation rates in the year preceding FeNO reading, suggesting that combining FeNO and BEC measurements in primary care may identify asthma patients at risk of exacerbations.
SUBMITTER: Price DB
PROVIDER: S-EPMC6702739 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Price David B DB Bosnic-Anticevich Sinthia S Pavord Ian D ID Roche Nicolas N Halpin David M G DMG Bjermer Leif L Usmani Omar S OS Brusselle Guy G Ming Simon Wan Yau SWY Rastogi Sarang S
Clinical and translational allergy 20190821
<h4>Background</h4>Blood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO) concentration are established biomarkers in asthma, associated particularly with the risk of exacerbations. We evaluated the relationship of BEC and FeNO as complementary and independent biomarkers of severe asthma exacerbations.<h4>Methods</h4>This observational study included data from the Optimum Patient Care Research Database. Asthma patients (18-80 years) with valid continuous data for 1 year before F ...[more]