A treatment algorithm based on actual measures of airway inflammation has been designed by Australian researchers to cut asthma exacerbations during pregnancy.
They developed a fraction of exhaled nitric oxide (FENO) based algorithm and tested it for adjusting corticosteroid treatment.
Previous work has shown that corticosteroid treatment for asthma may be more effective when based on actual measures of airway inflammation, and one possible measure is the FENO.
In this new study – the Managing Asthma in Pregnancy (MAP) trial – the authors developed an improved FENO-based treatment algorithm and tested its applicability for the adjustment of therapy for asthma during pregnancy.
MAP assessed 220 pregnant, non-smoking women with asthma, who were randomly assigned, before 22 weeks’ gestation, to treatment adjustment at monthly visits by an algorithm using clinical symptoms or FENO concentrations.
The exacerbation rate in the FENO algorithm group was around half that found in the symptom algorithm group (0·29 vs 0·62 exacerbations per pregnancy).
The authors conclude: “Asthma management during pregnancy can be improved by the use of measuring FENO concentration, and symptoms to adjust treatment.
“This algorithmic approach might also be beneficial for non-pregnant women with asthma,” they add.