{Reference Type}: Journal Article
{Title}: Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review.
{Author}: Pianigiani T;Alderighi L;Meocci M;Messina M;Perea B;Luzzi S;Bergantini L;D'Alessandro M;Refini RM;Bargagli E;Cameli P;
{Journal}: Antioxidants (Basel)
{Volume}: 12
{Issue}: 2
{Year}: Feb 2023 7
{Factor}: 7.675
{DOI}: 10.3390/antiox12020400
{Abstract}: <B>BACKGROUND: </B>Fractional exhaled nitric oxide (FeNO) is a biomarker of airway inflammation associated with airway hyper-responsiveness and type-2 inflammation. Its role in the management of severe asthmatic patients undergoing biologic treatment, as well as FeNO dynamics during biologic treatment, is largely unexplored.<BR><B>OBJECTIVE: </B>The aim was to evaluate published data contributing to the following areas: (1) FeNO as a predictive biomarker of response to biologic treatment; (2) the influence of biologic treatment in FeNO values; (3) FeNO as a biomarker for the prediction of exacerbations in patients treated with biologics.<BR><B>METHODS: </B>The systematic search was conducted on the Medline database through the Pubmed search engine, including all studies from 2009 to the present.<BR><B>RESULTS: </B>Higher baseline values of FeNO are associated with better clinical control in patients treated with omalizumab, dupilumab, and tezepelumab. FeNO dynamics during biologic treatment highlights a clear reduction in FeNO values in patients treated with anti-IL4/13 and anti-IL13, as well as in patients treated with tezepelumab. During the treatment, FeNO may help to predict clinical worsening and to differentiate eosinophilic from non-eosinophilic exacerbations.<BR><B>CONCLUSIONS: </B>Higher baseline FeNO levels appear to be associated with a greater benefit in terms of clinical control and reduction of exacerbation rate, while FeNO dynamics during biologic treatment remains a largely unexplored issue since few studies have investigated it as a primary outcome. FeNO remains detectable during biologic treatment, but its potential utility as a biomarker of clinical control is still unclear and represents an interesting research area to be developed.