The Use of Fractional Exhaled Nitric Oxide in the Identification of Non-adherence in Difficult Asthma
Status:
Completed
Trial end date:
2011-07-01
Target enrollment:
Participant gender:
Summary
Asthma usually responds to standard doses of inhaled steroids with or without additional
therapies to control their symptoms. However, approximately 5-10% do not respond to this
treatment strategy and are referred to as having difficult asthma. Evidence shows that this
poor response is not always related to asthma severity with non-adherence to treatment being
a common underlying problem, in 35% of subjects. Recognising non-adherence in the clinic is
problematic as there is no straightforward objective test to identify it.
Patients attending an asthma clinic whose symptoms are not controlled by standard treatment
will be assessed for airway inflammation using fractional exhaled nitric oxide, and sputum
analysis. These subjects will be observed taking their medication to determine if this
reduces their level of airway inflammation. Prescription records will be used to ascertain if
this test distinguishes those who are non-adherent with their treatment from those adults who
have severe asthma.
Identifying patients who are non-adherent to treatment will allow an appropriate change in
management and enable alternative strategies to be developed to tackle non-adherence in this
population. Distinguishing patients who are adherent to treatment but have therapy resistant
disease would significantly improve treatment effectiveness in this group by allowing these
patients to be suitably targeted with expensive novel therapies such as Omalizumab.
Phase:
N/A
Details
Lead Sponsor:
Liam Heaney
Collaborators:
Asthma UK Northern Ireland Chest Heart & Stroke Northern Ireland Chest Heart and Stroke Queen's University, Belfast