Combined assessment of bronchial asthma control using forced expiratory volume in first second and exhaled nitric oxide

Introduction
The principal goal of bronchial asthma (BA) management is to control and reduce the risk of exacerbations. Poor assessment of asthma control is a major cause of poor asthma management. This study aimed to detect the level of asthma control using spirometry and exhaled nitric oxide (FeNO).


Patients and methods
This study investigated 210 patients with a diagnosis of BA. Asthma control in included patients was classified according to the Global Initiative for Asthma symptom-based assessment of asthma control, into controlled, partly controlled, or uncontrolled. Spirometry and FeNO results were recorded.


Results
Most of the studied patients had partly controlled BA (43.3%), while uncontrolled BA was found in 29% of them. There was a significant association between both prebronchodilator forced expiratory volume in 1 s (FEV1) and the presence of reversibility with levels of BA control. There was no significant difference in the FeNO value between the levels of BA control (P=0.5). Combined assessment of BA using low FEV1 with high FeNO showed a significant difference between BA control groups.


Conclusion
A combination of FeNO and FEV1 provides a better method in detecting the level of BA control. It may be very important for patients with higher airway reversibility to consistently monitor disease control and then to modify therapeutic strategy.