Top Asthma Studies Will Reshape Treatment : Recent papers address topics ranging from theophylline to thermoplasty to nitric oxide.

There were 19 hospitalizations for respiratory symptoms in the thermoplasty arm, vs. 2 in the sham-therapy arm. There were no differences between the two groups in pulmonary function tests, medication use, or asthma-free days (Am. J. Respir. Crit. Care Med. 2010;181:116-24). Dr. Nelson said he'd like to see longer follow-up to better assess the procedure's long-term benefits.

▸ Serum vitamin D correlates inversely with childhood asthma severity: A study in 616 asthmatic children ages 6–14 years showed that 28% had an insufficient serum vitamin D level of 30 ng/mL or less. Serum vitamin D was inversely correlated with hospitalizations for asthma in the previous year, bronchial responsiveness to methacholine, total IgE, and circulating eosinophil counts (Am. J. Respir. Crit. Care Med. 2009;179:765-71).

▸ Daily telemonitoring of exhaled nitric oxide in the treatment of childhood asthma: Dutch investigators randomized 151 children with atopic asthma to management directed by daily symptom monitoring alone or in conjunction with daily telemonitoring of exhaled nitric oxide. Patients improved equally in both groups, meaning monitoring exhaled nitric oxide added nothing (Am. J. Respir. Crit. Care Med. 2009;179:93-7).

“There are now six studies in which exhaled nitric oxide was used to guide asthma management. None has shown a significant improvement with addition of exhaled nitric oxide,” Dr. Nelson said.

Dr. Nelson disclosed serving as a consultant to Abbott, AstraZeneca, Boehringer-Ingelheim, Dey, Dynavax Technologies, Dyson, Genentech, GlaxoSmithKline, Johnson & Johnson, MediciNova, Novartis, Schering-Plough, Sepracor, and Teva, and has received grant and research support from several of these companies.