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Anti-inflammatory T...
Anti-inflammatory Treatment of Atopic Asthma Guided by Exhaled Nitric Oxide : A Randomized, Controlled Trial
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- Syk, Jörgen (författare)
- Karolinska Institutet
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- Malinovschi, Andrei (författare)
- Uppsala universitet,Klinisk fysiologi
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- Johansson, Gunnar (författare)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Undén, Anna-Lena (författare)
- Karolinska Inst, Dept Neurobiol Caring Sci & Soc, Stockholm, Sweden
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- Andreasson, Anna (författare)
- Stockholms universitet,Stressforskningsinstitutet,Karolinska Institutet, Sweden,Karolinska Inst, Dept Neurobiol Caring Sci & Soc, Stockholm, Sweden.; Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden
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- Lekander, Mats (författare)
- Stockholms universitet,Stressforskningsinstitutet,Karolinska Institutet, Sweden,Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.; Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden
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- Alving, Kjell, 1959- (författare)
- Uppsala universitet,Pediatrik,Allmänpediatrisk forskning/Nordvall
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(creator_code:org_t)
- Elsevier BV, 2013
- 2013
- Engelska.
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825 .- 2213-2198 .- 2213-2201. ; 1:6, s. 639-648
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BackgroundAtopic asthma is characterized by Th2 cytokine–driven inflammation of the airway mucosa, which is signaled by the fraction of exhaled nitric oxide (FENO).ObjectiveWe tested whether an FENO-guided anti-inflammatory treatment algorithm could improve asthma-related quality of life and asthma symptom control, and reduce exacerbations in atopic asthmatics within primary care.MethodsAltogether, 187 patients with asthma and who were nonsmokers (age range, 18-64 years) with perennial allergy and who were on regular inhaled corticosteroid treatment were recruited at 17 primary health care centers, randomly assigned to 2 groups and followed up for 1 year. For the controls (n = 88), FENO measurement was blinded to both operator and patient, and anti-inflammatory treatment was adjusted according to usual care. In the active group (n = 93), treatment was adjusted according to FENO. Questionnaires on asthma-related quality of life (Mini Asthma Quality of Life Questionnaire) and asthma control (Asthma Control Questionnaire) were completed, and asthma events were noted.ResultsThe Asthma Control Questionnaire score change over 1 year improved significantly more in the FENO-guided group (–0.17 [interquartile range {IQR}, −0.67 to 0.17] vs 0 [−0.33 to 0.50]; P = .045), whereas the Mini Asthma Quality of Life Questionnaire score did not (0.23 [IQR, 0.07-0.73] vs 0.07 [IQR, −0.20 to 0.80]; P = .197). The change in Asthma Control Questionnaire was clinically important in subpopulations with poor control at baseline (P = .03). Furthermore, the exacerbation rate (exacerbations/patient/y) was reduced by almost 50% in the FENO-guided group (0.22 [CI, 0.14-0.34] vs 0.41 [CI, 0.29-0.58]; P = .024). Mean overall inhaled corticosteroid use was similar in both groups (P = .95).ConclusionUse of FENO to guide anti-inflammatory treatment within primary care significantly reduced the exacerbation rate and improved asthma symptom control without increasing overall inhaled corticosteroid use.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Asthma
- Atopy
- Breath test
- FENO
- Quality of life
- Exacerbation
- Corticosteroid
- Leukotriene receptor antagonist
- Primary care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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