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World Asthma Day

World Asthma Day 2025

World Asthma Day is celebrated on the 6th May 2025, bringing attention and awareness of this often under-diagnosed condition.1, 2 In this article we will look at some facts about asthma and why this important day matters to both patients and healthcare professionals alike.

Last updated: May 2025

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Globally, it’s estimated that 300 million people suffer with asthma, and around 1000 people die each day as a result of the condition.

World Asthma Day gives an opportunity to bring this often under-diagnosed condition1,2 front and centre. The theme for World Asthma Day 2025, set by the Global Initiative for Asthma (GINA) is “Make Inhaled Treatments Accessible for ALL”, emphasising the need for improved access to asthma care globally.3 Inhaled medications are crucial for disease control and for treating attacks.3

Globally, it’s estimated that 300 million people suffer with asthma, and around 1000 people die each day as a result of the condition.4,5 Shockingly, it is estimated that almost 2/3 of these could be prevented with better asthma management.6 This includes, but is not limited to, access to inhaled treatment, and yearly asthma reviews for ongoing monitoring of personalised asthma plans, medication effectiveness and adherence.7-9

The prevalence of under-diagnosed or under-treated asthma is greatest in low- and middle-income countries (LMICs), along with a disproportionately high burden of mortality.10,11 These countries account for approximately 90% of the asthma burden of disease.12 Some countries, such as Nigeria and those in Latin America, reporting very high rates of uncontrolled asthma of up to 90%.12-15

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Problems can often lie in the misdiagnosis of asthma.1 Research indicates that up to 73% of patients may go under-diagnosed, leaving many individuals potentially living with under- or un-treated asthma and at increased risk of potentially serious asthma attacks.1 Symptoms and lung function tests alone can be insufficient for diagnosing asthma, as both have limitations in identifying the underlying airway inflammation – a key characteristic of asthma.4,16 In fact, most patients with asthma have Type 2 airway inflammation17, so why not measure it?

FeNO (fractional exhaled nitric oxide) testing does just that.17 FeNO is a non-invasive and direct biomarker of Type 2 airway inflammation, measuring the amount of nitric oxide in exhaled breath, which is increased when inflammation is present.18,19 It is useful for diagnosis and management of asthma, providing an insight that standard tests may miss.16,19,20

Access to treatment is important, but getting patients onto the right treatment is crucial. A high FeNO is suggestive of an asthma diagnosis, but it is also predictive of responsiveness to inhaled corticosteroid (ICS) treatment.18 Due to its sensitivity to ICS, FeNO can support safe titration of dosage to avoid over- or under- treatment, monitor adherence and evaluate treatment effectiveness over time.18,21,22 It can support targeted and effective use of ICS allowing for a personalised approach to asthma care; helping to improve outcomes, ensure resources are used efficiently, and reduce asthma associated costs.18,23,24

What is FeNO Testing?

Fractional exhaled nitric oxide (FeNO) testing is a simple, non-invasive, and rapid point-of-care test to measure airway inflammation associated with Type 2 asthma.*

FeNO testing involves inhaling then exhaling through the device to measure a patient’s FeNO level and can be used on adults and children.**

FeNO testing is a quick and easy way to diagnose and manage asthma.*

* Alving K et al. Validation of a new portable exhaled nitric oxide analyzer, NIOX VERO®: randomized studies in asthma. Pulm Ther. 2017;3:207-218. ** NIOX®. Product Labelling Summary NIOX VERO®. 2023.

FeNO testing is becoming an increasingly popular tool for asthma care, with portable devices like the NIOX VERO® being used by healthcare professionals across the globe. 25 The NIOX VERO® FeNO testing device is simple, quick, and accurate, allowing for point-of-care decision making in clinical settings.26,27

Tools like this can help to get people onto treatment sooner, without the need for additional appointments for results or inappropriate referrals.23,24 Its use in asthma care is supported and recommended by many guidelines worldwide, including the Global Initiative for Asthma (GINA), American Thoracic Society (ATS), European Respiratory Society (ERS) and the National Institute for Health and Care Excellence (NICE/BTS/SIGN) joint guidelines, who recommend FeNO as a first-line diagnostic tool in both adults and children.4,9,21,28,29

This World Asthma Day, under the theme “Make Inhaled Treatments Accessible for ALL,” we are reminded that asthma care is not only about accessibility, it’s about equity, and ensuring that those who need it are given the right treatment as soon as possible. Tools like FeNO testing bring us one step closer to personalised asthma management, helping healthcare professionals identify the right patients for the right inhaled treatments, at the point-of-care.16,18,23,30 Providing clinicians with accurate tools is essential to closing the treatment gap and turning today’s awareness into tomorrow’s action.

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References:

  1. Kavanagh J et al. Over- and under-diagnosis in asthma. Breathe (Sheff). 2019;15(1):e20-e27. 
  2. Nolte H et al. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respiratory medicine. 2006;100(2):354-62. 
  3. GINA. World Asthma Day 2025. Available at: https://ginasthma.org/wad-2025/ Accessed: April 2025 
  4. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2024. Available at; https://ginasthma.org/2024-report/ 
  5. Global Asthma Network. The Global Asthma Report. 2022. 
  6. Royal College of Physicians (RCP). Why asthma still kills: the National Review of Asthma Deaths (NRAD). 2014. 
  7. NHS. Asthma Treatment. Available at: https://www.nhs.uk/conditions/asthma/treatment/. Accessed: April 2025 
  8. American Lung Association. Managing asthma. Available at: https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/managing-asthma. Accessed: April 2025 
  9. National Institute for Health and Care Excellence (NICE). Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). 2024. Available at; https://www.nice.org.uk/guidance/ng245 
  10. World Health Organisation (WHO). Asthma. Available at; https://www.who.int/news-room/fact-sheets/detail/asthma. Accessed; April 2025. 
  11. Meghji J et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021; 397: 928–940. 
  12. Mortimer K, et al. Asthma management in low- and middle-income countries: case for change. Eur Respir J. 2022;60(3):2103179 
  13. Gold L et al. Level of asthma control and healthcare utilization in Latin America. Allergy 2013; 68: 1463–1466. 
  14. Ozoh O et al. Asthma management and control in Nigeria: the asthma insight and reality Nigeria (AIRNIG) study. Expert Rev Respir Med. 2019; 13: 917–927. 
  15. Cançado J et al. Respira project: humanistic and economic burden of asthma in Brazil. J Asthma 2019; 56: 244–251. 
  16. 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. 
  17. Kaya T et al. The Fractional exhaled Nitric Oxide (FeNO)-test as add-on test in the diagnostic work-up of asthma: a study protocol. BMC Pulmonary Medicine. 2024;24(1):178. 
  18. Ali H et al. The Potential of Fractional Exhaled Nitric Oxide as a Biomarker in Predicting and Optimizing Use of Treatment in Asthma. South East European Journal of Immunology. 2023;6(1):18-23. 
  19. Rickard K et al. Measurement of exhaled nitric oxide in young children. Annals of Allergy, Asthma & Immunology. 2019;122(3):343-5. 
  20. Price DB et al. Fractional exhaled nitric oxide as a predictor of response to inhaled corticosteroids in patients with non-specific respiratory symptoms and insignificant bronchodilator reversibility: a randomised controlled trial. Lancet Respir Med. 2018;6(1):29-39. 
  21. Louis R et al. European Respiratory Society guidelines for the diagnosis of asthma in adults. European Respiratory Journal. 2022;60(3). 
  22. Wang K et al. Using fractional exhaled nitric oxide to guide step-down treatment decisions in patients with asthma: a systematic review and individual patient data meta-analysis. Eur Respir J. 2020;55(5):1902150. 
  23. Loewenthal L et al. FeNO in asthma. Semin Respir Crit Care Med. 2022;43:635-645 
  24. NHS England. Fractional Exhaled Nitric Oxide (FeNO). Available at; https://www.england.nhs.uk/aac/what-we-do/innovation-for-healthcare-inequalities-programme/rapid-uptake-products/fractional-exhaled-nitric-oxide/. 
  25. NIOX®. Data on File; MKT-DOF-013. 2025. 
  26. Alving K et al. Validation of a new portable exhaled nitric oxide analyzer, NIOX VERO®: randomized studies in asthma. Pulm Ther. 2017;3:207-18. 
  27. Carroll WD. NIOX VERO: Individualized Asthma Management in Clinical Practice. Pulmonary Therapy. 2016;2:171-88. 
  28. 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. 
  29. Dweik RA et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602-15.  
  30. Wang K et al. Fractional exhaled nitric oxide (FeNO): the future of asthma care?. The British Journal of General Practice. 2023;73(737):565. 


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