Objectives Fractional exhaled nitric oxide (FeNO) has been implicated as a pulmonary biomarker in various respiratory disease, including COPD. Measurement of FeNO is a simple, non-invasive tool for assessing airway inflammation. Neverthless, the usefulness of FeNO measurements in COPD patient in clinical practice is unclear. The objective of this review was to evaluate the efficacy of management of COPD based on FeNO in comparison with pulmonary function test.
Method Cochrane library (CENTRAL), MEDLINE, EMBASE and reference lists of articles were searched. The last searches were in July 2013. Results of searches were reviewed against predominantly criteria for inclusion. Relevant studies were selected, assessed and data extracted independently by two people. Participant articles with COPD management based on pulmonary function test compared with FeNO measurement were selected. Risk of bias for each study was assessed using the QUADAS(quality assessment of studies of diagnosis accuracy included in systematic reviews) scale.
Results Finally, eight studies were included. Of the eight studies, four were a negative and one were positive correlation between FeNO and pulmonary functions. Three studies were not significant correlation. The various results of studies were effected by characteristics of the patients (COPD severity, smoking status, treatment status) and differences in FeNO measurement methods.
Conclusions The studies includes in this review highlight the difficulties of correlation between FeNO and pulmonary function. So, the role of add-on monitoring of FeNO to pulmonary function test is less clear because of the absence of conclusive double-blind, randomised, control studies concerning potential clinical benefits in the management of COPD. Further randomised controlled trials are required.
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