Results of Aberdeen led Children Asthma Study published

RAACENO is short for Reducing Asthma Attacks in Children using Exhaled Nitric Oxide. The RAACENO randomised clinical trial looked at whether the addition of exhaled nitric oxide to routine asthma care reduced asthma attacks in children. The trial website can be found here RAACENO

Background: Asthma affects 1 million children in the UK [1]. Asthma treatment is stepped up in the presence of increasing symptoms and stepped down with decreasing symptoms. There is no biological test or biomarker that can support symptom-based treatment decisions. A candidate biomarker for asthma severity is exhaled nitric oxide. Nitric oxide is a gas that we all produce and exhale with our breath. People with asthma exhale more nitric oxide because of their allergic cells in the lungs. These allergic cells build up before and asthma attack.

Aim: In this study the researchers wanted to find out if children whose doctors used exhaled nitric oxide measurement on top of their usual practice would have less frequent asthma attacks than children whose doctors use the usual assessment.

Results: 509 children were recruited, predominantly from hospital asthma clinics across the UK. It was found that adding exhaled nitric oxide measurements to the usual symptom guided treatment did not reduce the frequency of asthma attack in the children in this study.

Professor Stephen Turner, consultant at the Royal Aberdeen Children Hospital told us why this is important: “There is uncertainty concerning the role of nitric oxide measurements (FeNO) in guiding childhood asthma. National asthma guidelines do not recommend its routine use but a Cochrane review found FeNO guided treatment was associated with reduced asthma attacks. The RAACENO study clarifies that children attending hospital asthma clinics do not benefit from the addition of FeNO to routine care.”

The results of the RAACENO study have been published in the journal The Lancet Respiratory Medicine. DOI: https://doi.org/10.1016/S2213-2600(21)00486-0

This study was funded by the Efficacy and Mechanism Evaluation (EME) Programme of the National Institute for Health Research (NIHR). Please visit the NIHR website for more information: www.nihr.ac.uk.

1 Asthma statistics | British Lung Foundation (blf.org.uk)