Asthma Awareness Month series Part Two: Why should you be using FeNO?

Why should you use FeNO in your clinic?

• FeNO testing is quick, simple and non-invasive

It simply involves inhaling and exhaling through the device at about the same pressure as blowing bubbles into a drink through a straw. The results are immediate, with the test only taking around 2 minutes from inhalation to results.

• See inflammation clearly

FeNO testing gives you a clear picture of the inflammation in patients lungs.(1) It is the only non-invasive asthma diagnostics tool which accurately and specifically shows the level of inflammation in the airways.(1-4) Asthma is 7x more likely with high FeNO.(5)

• Improve patient outcomes

You can use FeNO to manage patients’ asthma and identify non-adherence, which can reduce morbidity and mortality.(2,6-8) FeNO testing has been shown to reduce the chance of exacerbations by around 50% in adults and children.(9,10)

• Guidelines

FeNO testing is recommended in many guidelines for the diagnosis and management of asthma, such as the American Thoracic Society, European Respiratory Society, and the Global Initiative for Asthma.(8,11-13)

• FeNO is cost effective

Up to 75% of costs associated with asthma may be due to poor asthma control, but helping patients to control their asthma could reduce this.(2,14,15) It is estimated that FeNO testing could result in ￡147 million in savings in the UK.(16)

?

We hope that this gives you a small insight into what FeNO can do in the clinic. If this has interested you, check out niox.com for more information about FeNO and NIOX?.

Look out for Part 3 coming soon!

References:

1. Hanania NA et al. Measurement of fractional exhaled nitric oxide in real-world clinical practice alters asthma treatment decisions. Ann Allergy Asthma Immunol. 2018;120(4):414-418.
2. Loewenthal L et al. FeNO in asthma. Semin Respir Crit Care Med. 2022;43:635-645
3. Carroll WD. NIOX VERO: Individualized Asthma Management in Clinical Practice. Pulmonary Therapy. 2016;2:171-88.
4. Gao J et al. Association between fractional exhaled nitric oxide, sputum induction and peripheral blood eosinophil in uncontrolled asthma. Allergy, Asthma & Clinical Immunology. 2018;1
5. Wang Z et al. Agency for Healthcare Research and Quality (AHRQ). The clinical utility of fractional exhaled nitric oxide (FeNO) in asthma management. Comparative Effectiveness Reviews, 197. 2017.
6. Menzies-Gow A et al. Clinical utility of fractional exhaled nitric oxide in severe asthma management. Eur Respir J. 2020;55(3):1901633.
7. Barry LE et al. Cost-Effectiveness of Fractional Exhaled Nitric Oxide Suppression Testing as an Adherence Screening Tool Among Patients With Difficult-to-Control Asthma. The Journal of Allergy and Clinical Immunology: In Practice. 2023.
8. Khatri SB et al. An official American Thoracic Society clinical practice guideline: use of fractional exhaled nitric oxide to guide the treatment of asthma. Am J Respir Crit Care Med. 2021;204(10):e97-e109.
9. Petsky HL et al. Exhaled nitric oxide levels to guide treatment for adults with asthma. Cochrane Database Syst Rev. 2016;9(9):CD011440.
10. Petsky HL et al. Exhaled nitric oxide levels to guide treatment for children with asthma. Cochrane Database Syst Rev. 2016;11(11):CD011439.
11. Louis R et al. European Respiratory Society guidelines for the diagnosis of asthma in adults. European Respiratory Journal. 2022;60(3).
12. American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005;171(8):912-30.
13. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2023. Available at; https://ginasthma.org/2023-gina-main-report/ Accessed: April 2024
14. Apter AJ. Enhancing patients adherence to asthma therapy. Up to Date. Last updated; September 2022. Available at; https://www.uptodate.com/contents/enhancing-patient-adherence-to-asthma-therapy . Accessed: April 2024
15. World Health Organization (WHO). Asthma. Available at; https://www.who.int/news-room/fact-sheets/detail/asthma . Accessed; Apr 2024.
16. Asthma and Lung. Investing in Breath: Measuring the economic cost of asthma and COPD in the UK and identifying wats to reduce it through better diagnosis and care. Technical report