Trial Outcomes & Findings for A Study to Explore the Utility of Fractional Exhaled Nitric Oxide (FeNO) Compared With Methacholine Challenge (MCC) Testing in the Assessment of Patients With Suspected But Undiagnosed Asthma (NCT NCT01648920)

NCT ID: NCT01648920

Last Updated: 2014-04-09

Results Overview

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

• Recruitment status: COMPLETED
• Target enrollment: 50 participants
• Primary outcome timeframe: approximately 1-hour
• Results posted on: 2014-04-09

Participant Flow

Participant milestones

Measure	FeNO Participants with suspected but undiagnosed asthma had a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they had a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Overall Study STARTED	50
Overall Study COMPLETED	50
Overall Study NOT COMPLETED	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Study to Explore the Utility of Fractional Exhaled Nitric Oxide (FeNO) Compared With Methacholine Challenge (MCC) Testing in the Assessment of Patients With Suspected But Undiagnosed Asthma

Baseline characteristics by cohort

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma had a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they had a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Age, Continuous	24.7 years n=5 Participants
Sex: Female, Male Female	23 Participants n=5 Participants
Sex: Female, Male Male	27 Participants n=5 Participants
Region of Enrollment United States	50 participants n=5 Participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Methacholine Challenge (MCC) Results >= 20% decrease in FEV1 from BL MCC Dilution	14 participants
Methacholine Challenge (MCC) Results <20% Decrease in FEV1 from BL MCC Dilution	36 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Mean FeNO Levels by Methacholine Challenge (MCC) Results: MCC Results >= 20% decrease in FEV1 from BL MCC Dilution	17.4 parts per billion (ppb) Standard Deviation 12.54
Mean FeNO Levels by Methacholine Challenge (MCC) Results: MCC Results <20% Decrease in FEV1 from BL MCC Dilution	17.7 parts per billion (ppb) Standard Deviation 9.77

PRIMARY outcome

Timeframe: approximately 1-hour

Population: Participants with a FeNO \< 25 ppb

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. A positive response to methacholine challenge is defined as a greater than or equal to 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline in response to methacholine. A negative response to methacholine challenge is defined as a less than 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline.

Outcome measures

Measure	FeNO n=38 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO by Methacholine Challenge (MCC) Results: FeNO <25ppb Positive Response to MCC	12 participants
FeNO by Methacholine Challenge (MCC) Results: FeNO <25ppb Negative Response to MCC	26 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Population: Participants with FeNO \>= 25 ppb to \<= 50 ppb

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. A positive response to methacholine challenge is defined as a greater than or equal to 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline in response to methacholine. A negative response to methacholine challenge is defined as a less than 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline.

Outcome measures

Measure	FeNO n=11 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO by Methacholine Challenge (MCC) Results: FeNO >=25ppb to <=50ppb Positive Response to MCC	1 participants
FeNO by Methacholine Challenge (MCC) Results: FeNO >=25ppb to <=50ppb Negative Response to MCC	10 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Population: Participants with FeNO \>50ppb

Fractional Exhaled Nitric Oxide (FeNO) measurements will be performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests will be performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. A positive response to methacholine challenge is defined as a greater than or equal to 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline in response to methacholine. A negative response to methacholine challenge is defined as a less than 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline.

Outcome measures

Measure	FeNO n=1 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO by Methacholine Challenge (MCC) Results: FeNO >50ppb Positive Response to MCC	1 participants
FeNO by Methacholine Challenge (MCC) Results: FeNO >50ppb Negative Response to MCC	0 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements was performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. A positive response to methacholine challenge is defined as a greater than or equal to 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline in response to methacholine.

Outcome measures

Measure	FeNO n=14 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by MCC Results: Positive MCC Response Asthma	11 participants
Asthma Diagnosis by MCC Results: Positive MCC Response Non-Asthma	3 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements was performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. A negative response to methacholine challenge is defined as a less than 20% decrease in FEV1 at a methacholine dose less than or equal to 16mg/ml from baseline.

Outcome measures

Measure	FeNO n=36 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by MCC Results: Negative MCC Response Asthma	0 participants
Asthma Diagnosis by MCC Results: Negative MCC Response Non-Asthma	36 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=38 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by FeNO: FeNO <25ppb Asthma	10 participants
Asthma Diagnosis by FeNO: FeNO <25ppb Non-Asthma	28 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=11 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by FeNO: FeNO >=25ppb to <= 50ppb Asthma	0 participants
Asthma Diagnosis by FeNO: FeNO >=25ppb to <= 50ppb Non-Asthma	11 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=1 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by FeNO: FeNO >50ppb Asthma	1 participants
Asthma Diagnosis by FeNO: FeNO >50ppb Non-Asthma	0 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Asthma Diagnosis by FeNO: Mean FeNO Value Asthma	16.9 Parts per billion (ppb) Standard Deviation 12.21
Asthma Diagnosis by FeNO: Mean FeNO Value Non-Asthma	17.8 Parts per billion (ppb) Standard Deviation 10.11

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. Sensitivity is a way of saying how likely a test is positive if you have a disease and is expressed as (%) percent. For this study, sensitivity was the ability of FeNO to correctly identify a study participant who has asthma.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Sensitivity (%) for FeNO FeNO <= 10 ppb	35.7 percent
Sensitivity (%) for FeNO FeNO <= 15 ppb	57.1 percent
Sensitivity (%) for FeNO FeNO <=20 ppb	85.7 percent
Sensitivity (%) for FeNO FeNO <=25 ppb	85.7 percent
Sensitivity (%) for FeNO FeNO <=30 ppb	85.7 percent
Sensitivity (%) for FeNO FeNO <= 35 ppb	85.7 percent
Sensitivity (%) for FeNO FeNO <= 40 ppb	92.9 percent
Sensitivity (%) for FeNO FeNO <= 45 ppb	92.9 percent
Sensitivity (%) for FeNO FeNO <= 50 ppb	92.9 percent
Sensitivity (%) for FeNO FeNO <= 55 ppb	100.0 percent

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. Specificity is a way of saying how likely a test is negative if you do not have a disease and is expressed as (%) percent. For this study, specificity was the ability of FeNO to correctly identify a study participant who does not have asthma.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Specificity (%) for FeNO FeNO <= 10 ppb	75.0 percent
Specificity (%) for FeNO FeNO <= 15 ppb	55.6 percent
Specificity (%) for FeNO FeNO <=20 ppb	33.3 percent
Specificity (%) for FeNO FeNO <=25 ppb	25.0 percent
Specificity (%) for FeNO FeNO <=30 ppb	11.1 percent
Specificity (%) for FeNO FeNO <= 35 ppb	2.8 percent
Specificity (%) for FeNO FeNO <= 40 ppb	2.8 percent
Specificity (%) for FeNO FeNO <= 45 ppb	0.0 percent
Specificity (%) for FeNO FeNO <= 50 ppb	0.0 percent
Specificity (%) for FeNO FeNO <= 55 ppb	0.0 percent

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. Positive predictive value is a way of saying the likelihood a positive test means you have a disease. In this study, it is defined as the percentage of study participants with a high FeNO who have asthma.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Positive Predictive Value (%) for FeNO FeNO <= 10 ppb	35.7 percent
Positive Predictive Value (%) for FeNO FeNO <= 15 ppb	33.3 percent
Positive Predictive Value (%) for FeNO FeNO <=20 ppb	33.3 percent
Positive Predictive Value (%) for FeNO FeNO <=25 ppb	30.8 percent
Positive Predictive Value (%) for FeNO FeNO <=30 ppb	27.3 percent
Positive Predictive Value (%) for FeNO FeNO <= 35 ppb	25.5 percent
Positive Predictive Value (%) for FeNO FeNO <= 40 ppb	27.1 percent
Positive Predictive Value (%) for FeNO FeNO <= 45 ppb	26.5 percent
Positive Predictive Value (%) for FeNO FeNO <= 50 ppb	26.5 percent
Positive Predictive Value (%) for FeNO FeNO <= 55 ppb	28.0 percent

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests will be compared against final asthma diagnosis. Negative predictive value is a way of saying the likelihood of a negative test means you do not have disease. In this study it is defined as the percentage of study participants with a low FeNO who do not have asthma.

Outcome measures

Measure	FeNO n=50 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
Negative Predictive Value (%) for FeNO FeNO <= 10 ppb	75.0 percent
Negative Predictive Value (%) for FeNO FeNO <= 15 ppb	76.9 percent
Negative Predictive Value (%) for FeNO FeNO <=20 ppb	85.7 percent
Negative Predictive Value (%) for FeNO FeNO <=25 ppb	81.8 percent
Negative Predictive Value (%) for FeNO FeNO <=30 ppb	66.7 percent
Negative Predictive Value (%) for FeNO FeNO <= 35 ppb	33.3 percent
Negative Predictive Value (%) for FeNO FeNO <= 40 ppb	50.0 percent

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO <25ppb who either did not use Inhaled Corticosteroids (ICS) or did use Inhaled Corticosteroids.

Outcome measures

Measure	FeNO n=38 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by ICS Use: FeNO <25ppb No ICS Use	34 participants
FeNO Values by ICS Use: FeNO <25ppb Yes ICS Use	4 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO >=50ppb who either did not use Inhaled Corticosteroids (ICS) or did use Inhaled Corticosteroids.

Outcome measures

Measure	FeNO n=1 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by ICS Use: FeNO >= 50ppb No ICS Use	1 participants
FeNO Values by ICS Use: FeNO >= 50ppb Yes ICS Use	0 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO <=25ppb to <=50ppb who either did not use Inhaled Corticosteroids (ICS) or did use Inhaled Corticosteroids.

Outcome measures

Measure	FeNO n=11 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by ICS Use: FeNO >= 25ppb to <= 50ppb No ICS Use	10 participants
FeNO Values by ICS Use: FeNO >= 25ppb to <= 50ppb Yes ICS Use	1 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO <25ppb who either did not smoke previously or are current smokers.

Outcome measures

Measure	FeNO n=38 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by Smoking Status: FeNO <25ppb No Previous Smoker	34 participants
FeNO Values by Smoking Status: FeNO <25ppb Current Smoker	4 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO >=25ppb to <=50ppb who either did not smoke previously or are current smokers.

Outcome measures

Measure	FeNO n=11 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by Smoking Status: FeNO >= 25ppb to <= 50ppb No Previous Smoker	11 participants
FeNO Values by Smoking Status: FeNO >= 25ppb to <= 50ppb Current Smoker	0 participants

PRIMARY outcome

Timeframe: approximately 1-hour

Fractional Exhaled Nitric Oxide (FeNO) measurements were performed according to the "Perform FeNO Measurement" guidelines on page 7 of the NIOX MINO® User Manual (February, 2011). Methacholine Challenge (MCC) tests were performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests. Values from the two tests were compared against final asthma diagnosis. Data are presented for participants with FeNO >=50ppb who either did not smoke previously or are current smokers.

Outcome measures

Measure	FeNO n=1 Participants Participants with suspected but undiagnosed asthma will have a fractional exhaled nitric oxide (FeNO) measurement taken by NIOX MINO® Instrument (09-1100) according to the 'Perform FeNO Measurement' guidelines on page 7 of the NIOX MINO® User Manual (February 2011) during their study visit. Following that they will have a Methacholine Challenge (MCC) test performed according to the ATS guidelines and the Allergy and Asthma Specialists Procedure for conducting MCC tests NIOX MINO® Instrument (09-1100): The NIOX MINO® Instrument (09-1100) is a 10 second test based on exhaled breath measured at a 50 ml/second flow rate.
FeNO Values by Smoking Status: FeNO >= 50ppb Current Smoker	1 participants
FeNO Values by Smoking Status: FeNO >= 50ppb No Previous Smoker	0 participants

Adverse Events

FeNO

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Nancy Herje, BSN, RN, MBA. Director, Clinical Development and Medical Affairs

Aerocrine, Inc.

Phone: 919-449-8873

Email: nancy.herje@aerocrine.com

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place

Restriction type: LTE60