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ACT scores, FEV1 and FeNO correlation and interaction in asthma control Dogan Ismail, Guven Kasim , Musellim Benan , Gemicioglu Bilun Istanbul University, Faculty of Medicine Cerrahpasa, Department of Pulmonary Diseases. . BACKGROUND: ACT.
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ACT scores, FEV1 and FeNO correlation and interaction in asthma control Dogan Ismail, Guven Kasim, Musellim Benan, Gemicioglu Bilun Istanbul University, Faculty of Medicine Cerrahpasa, Department of Pulmonary Diseases .
BACKGROUND: ACT • In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home? Score • During the past 4 weeks, how often have you had shortness of breath? • During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night, or earlier than usual in the morning? • During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)? • How would you rate your asthma control during the past 4 weeks?
AIM • To identify the correlation between ACT, FeNO levels and pulmonary functions • To demonstrate the interactions between ACT, FeNO with several parameters. .
METHOD 416 persistent asthma patients on combined therapy. All patients responded prepared demographic and comorbidities questionnaire and ACT FeNO, PFT, Skin prick test was done in all of them. Statistical analysis .
Materials ACT: Nathan R A et al. JACI 2004 Pulmonary functions tests: ZAN 100 Flow HandyII, Germany FeNO: NIOX Mino, Aerocrine AB, Solna Sweden Skin prick test: ALK Abello Spain Soluprick set Statistical analysis and correlation: SPSS 15:0
ACT & %FEV1 correlation r= 0,22 p < 0,001
FeNO & ACT correlation r= - 0,31 p= - 0,002
Hospitalization, Emergency Visit ACT and FeNO values varied significantly in patients with and without emergency visit history (p<0,001, p=0,02). While ACT was statistically different in patients with and without hospitalization history (p< 0,001), no difference was observed for FeNO.
ACT & Emergency Room Visit Yes No p < 0,001
FeNO & Emergency Rooom Visit Yes No p= - 0,02
ACT & Hospitalization Yes No p< 0,001
FeNO & gender interaction Female Male p= - 0,005
FeNO & Age correlation r= - 0,13 p= - 0,009
FeNO & duration of asthma correlation r= -0,15 p= - 0,008 Duration of asthma (year)
Smoking History FeNO and ACT were not different in patients with and without smoking history
Skin Prick Test Results % FeNO was statistically different in patients with positive and negative skin prick test (p=0,004), whereas no difference was noted for ACT (p>0,05))
FeNO & Skin Prick Test Allergic Nonallergic p = 0,004
Comorbidities ACT was not different in patients with and without allergic rhinitis, but it was significant for FeNO (p=0,008). FeNO and ACT values were different in patients with and without allergic conjunctivitis (p=0,02, p=0,03 respectively).
FeNO & Allergic Rhinitis ( +) ( - ) p = 0,008
FeNO & Allergic Conjunctivitis ( +) ( - ) p = 0,02
ACT & Allergic Conjunctivitis ( +) ( - ) p = 0,03
CONCLUSION • ACT and FEV1 were positively correlated whereas FEV1 and FeNO were not. FeNO measurement, in patients whose asthma was controlled according to ACT, seems to be significant in terms of treatment management. • As possible interactions between FeNO and various parameters have been shown; each patient should be individually assessed according to his/her best FeNO value. .