Measurement of eNO with portable analyser might improve the management of persistent cough at primary care practice in Japan. (26th November 2014)

• Record Type: Journal Article
• Authors: Watanabe, Keisuke; Shinkai, Masaharu; Shinoda, Masahiro; Hara, Yu; Yamaguchi, Nobuhiro; Rubin, Bruce K.; Ishigatsubo, Yoshiaki; Kaneko, Takeshi
• Is Part Of: Clinical respiratory journal. Volume 10:Number 3(2016)
• Page Start: 380
• Page End: 388
• Publication Date: 2014-11-26
• Subjects: cough -- exhaled nitric oxide -- inhaled corticosteroids -- primary care practice; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12228
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Background and Aims: There are some controversial reports that investigated the usefulness of exhaled nitric oxide (eNO) to predict the efficacy of inhaled corticosteroids (ICS) in chronic cough patients. Therefore, we retrospectively analysed the usefulness of eNO measurement with portable analyser to predict the requirement of ICS therapy in persistent cough (defined as lasting for 3 weeks or more) patients in Japan and investigated whether it might improve the management of persistent cough at primary care practice. Methods: We retrospectively reviewed the clinical records of adult patients who had been referred to our hospital for persistent cough from 1 June 2009 to 30 April 2011. Results: Forty‐two patients had the requirement of ICS (group S) and 35 patients had no requirement of ICS (group N). Forty‐three per cent of the patients who required ICS had not received ICS, and 29% of the patients who did not required ICS had received ICS. In the steroid‐naive patients without current smoking, mean eNO level was significantly higher in group S [60.6 ± 14.1 perts per billion (ppb) vs 22.2 ± 2.3 ppb, P = 0.001] and the sensitivity and the specificity of eNO for predicting the requirement of ICS were 78.6% and 80.0%, respectively. The rate of the patients who received inappropriate treatment about ICS tended to be reduced from 41% to 21% if the eNO was used to predict the requirement of ICS with cut‐off value of eNO 26.5 ppb ( P = 0.118). Conclusion: Measurement of eNO could be one of the management tools for persistent cough at primary care practice.