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已发表论文
FeNO下降率与COPD症状改善的关联：一项真实世界观察研究
Authors Li B, Liu M , Shi H, Wang Y , Meng X, An Z
Received 29 August 2025
Accepted for publication 5 January 2026
Published 21 January 2026 Volume 2026:21 563981
DOI https://doi.org/10.2147/COPD.S563981
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Vanesa Bellou
Boyu Li,1 Meishan Liu,2,3 Honglei Shi,2 Ying Wang,2 Xiaoni Meng,4 Zhuoling An1
1Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital, ShenZhen, People’s Republic of China; 4Evidence-Based Medicine Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
Correspondence: Zhuoling An, Department of Pharmacy, Beijing Chao-yang Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel/Fax +86 010 85231362, Email anzhuoling@163.com
Background: The association between relative changes in fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) with patient-reported symptoms improvements remains uncertain.
Objective: To assess the association of the rate of FeNO decline with the achievement of the minimum clinically important difference (MCID) in COPD Assessment Test (CAT) score.
Methods: We conducted a single-center, retrospective real-world study involving 111 adults with COPD. Patients were classified into two groups: those with symptom improvement (CAT decline ≥ 2 points) and those with no improvement (CAT decline < 2 points). Logistic regression evaluated associations between FeNO decline rate and CAT MCID, adjusting for clinically relevant covariates. Receiver operating characteristic (ROC) curve analysis estimated the discriminatory performances of it.
Results: Of 111 patients, 53 (47.7%) achieved the CAT MCID. Multivariate logistic regression found that the rate of FeNO decline was independently associated with symptom improvement (adjusted OR 2.08, 95% CI 1.01– 4.29, P=0.047). Baseline CAT also showed association with symptom improvement (adjusted OR 1.06, 95% CI 1.00– 1.12, P=0.034). BMI showed a positive trend but without statistical significance (adjusted OR 1.13, 95% CI 1.00– 1.29, P=0.056). AUC of FeNO decline rate, baseline CAT, combined with BMI in discriminating CAT MCID were 0.713 (95% CI 0.617, 0.809).
Conclusion: The rate of FeNO decline was significantly associated with clinically meaningful CAT improvement in this study, which indicated dynamic measures of type-2 inflammation can complement blood eosinophil counts to refine phenotyping and inform precision management in COPD.
Keywords: COPD, the rate of FeNO declined, CAT MCID, type-2 inflammation, treatable traits, precision medicine
1Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital, ShenZhen, People’s Republic of China; 4Evidence-Based Medicine Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
Correspondence: Zhuoling An, Department of Pharmacy, Beijing Chao-yang Hospital, Capital Medical University, Beijing, People’s Republic of China, Tel/Fax +86 010 85231362, Email anzhuoling@163.com
Background: The association between relative changes in fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) with patient-reported symptoms improvements remains uncertain.
Objective: To assess the association of the rate of FeNO decline with the achievement of the minimum clinically important difference (MCID) in COPD Assessment Test (CAT) score.
Methods: We conducted a single-center, retrospective real-world study involving 111 adults with COPD. Patients were classified into two groups: those with symptom improvement (CAT decline ≥ 2 points) and those with no improvement (CAT decline < 2 points). Logistic regression evaluated associations between FeNO decline rate and CAT MCID, adjusting for clinically relevant covariates. Receiver operating characteristic (ROC) curve analysis estimated the discriminatory performances of it.
Results: Of 111 patients, 53 (47.7%) achieved the CAT MCID. Multivariate logistic regression found that the rate of FeNO decline was independently associated with symptom improvement (adjusted OR 2.08, 95% CI 1.01– 4.29, P=0.047). Baseline CAT also showed association with symptom improvement (adjusted OR 1.06, 95% CI 1.00– 1.12, P=0.034). BMI showed a positive trend but without statistical significance (adjusted OR 1.13, 95% CI 1.00– 1.29, P=0.056). AUC of FeNO decline rate, baseline CAT, combined with BMI in discriminating CAT MCID were 0.713 (95% CI 0.617, 0.809).
Conclusion: The rate of FeNO decline was significantly associated with clinically meaningful CAT improvement in this study, which indicated dynamic measures of type-2 inflammation can complement blood eosinophil counts to refine phenotyping and inform precision management in COPD.
Keywords: COPD, the rate of FeNO declined, CAT MCID, type-2 inflammation, treatable traits, precision medicine