Inhaled fluticasone diproprionate decreases levels of nitric oxide in recurrently wheezy infants

We examined the effect of inhaled fluticasone diproprionate (FDP) on symptoms, lung function (FEV0.5), and exhaled nitric oxide (FeNO) in infants with recurrent wheeze and raised FeNO. Thirty-one infants aged 6–19 months (mean, 12.7 months; 12 girls) completed the study. All infants had a history of recurrent wheeze and a parental history of atopy. All children had raised FeNO, as determined by an offline tidal breathing technique prior to randomization. Lung function and FeNO were assessed before and after 4 weeks of treatment with FDP or placebo. The parents recorded daily symptoms during the treatment period. Sixteen infants received FDP and 15 the placebo for 4 weeks. At completion of the study, infants treated with FDP had a significant reduction in FeNO (35.0 ppb to 16.5 ppb) compared to those that received placebo (35.2 ppb to 30.2 ppb) (P = 0.05). Small increases in FEV0.5 were observed in both groups, but these changes were not different between groups (P = 0.8). Symptom scores were not significantly different in either group following the intervention. We showed that a moderate dose of inhaled FDP reduces levels of FeNO, a potential marker of airway inflammation, even in the absence of significant changes in lung function and symptoms. © 2004 Wiley-Liss, Inc.