Discover FeNO Testing:
What is FeNO?
FeNO stands for fractional exhaled nitric oxide and is the only available point of care test to assess type-2 inflammation in asthma.3 The results are available immediately, which allows for a quick diagnosis and treatment.4
There are no blood, sweat or tears required for a patient to perform a FeNO test.1.5 Testing takes less than 2 minutes with results being accurate and reliable with NIOX VERO®.5-8
Asthma: an inflammatory condition
Asthma is a chronic respiratory condition which affects around 300 million people globally.9 It is usually characterised by airway inflammation, and is defined by the history of several symptoms, such as wheeze, cough, shortness of breath, and chest tightness, all of which can vary over time and intensity.9
Asthma has many triggers, including exercise, allergen or irritant exposure, change in weather, and even viral respiratory infections.9
Help your patients to breathe easier
FeNO is a convenient test to use at the point-of-care, which is why it is used in a variety of healthcare environments, from pharmacy to secondary care.5,10,11 A simple, quick, and non-invasive test that helps uncover airway inflammation, assisting you in the diagnosis and management of your asthma patients.1,5,10Test FeNO with the NIOX VERO®, a portable, desk-top, FeNO device.
Using FeNO as an asthma risk estimator can help reduce the chance of exacerbations by up to 50% and is valuable in many healthcare settings.7,10,12-14Understanding the level of inflammation with FeNO can help improve asthma care; from monitoring adherence, titrating ICS dosage, to guiding biologics treatment.10,15,16
Understanding FeNO Levels
Many national and international guidelines recommend FeNO testing for the diagnosis and management of asthma.9,17-20 In 2011, the American Thoracic Society (ATS) produced a guideline recommending the cut-off points to interpret FeNO today.17 Data has also highlighted that asthma is 7x more likely with a FeNO level above 40 ppb.21
Interpret FeNO results
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References:
1. 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.
2. 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/.
3. Kuo C et al. Scottish consensus statement on the role of FeNO in adult asthma. Respiratory medicine. 2019;155:54-7.
4. Czubaj-Kowal M et al. Relationship between air pollution and the concentration of nitric oxide in the exhaled air (feno) in 8–9-year-old school children in Krakow. International Journal of Environmental Research and Public Health. 2021;18(13):6690.
5. 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.
6. 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
7. Price D 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.
8. Crater G et al. Successful fractional exhaled nitric oxide measurements with NIOX VERO using 6-and 10-s exhalation modes in children with asthma aged 4–10 years: a randomized study. Pulm Ther. 2017;3:139-48.
9. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2024. Available at; https://ginasthma.org/2024-report/
10. Menzies-Gow A et al. Clinical utility of fractional exhaled nitric oxide in severe asthma management. Eur Respir J. 2020;55(3):1901633.
11. NIOX®. Data on File; MKT-DOF-013. 2024.
12. Petsky HL et al. Tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils): a systematic review and meta-analysis. Thorax. 2018;73(12):1110-9.
13. Health Innovation Manchester. GM leads the way in Asthma care for patients through the FeNO testing model and structured reviews in community pharmacy focusing on reducing over-reliance to SABA inhalers. 2023. Available at: https://healthinnovationmanchester.com/news/gm-leads-the-way-in-asthma-care-for-patients-through-the-feno-testing-model-and-structured-reviews-in-community-pharmacy-focusing-on-reducing-over-reliance-to-saba-inhalers/
14. 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.
15. Loewenthal L et al. FeNO in asthma. Semin Respir Crit Care Med. 2022;43:635-645
16. Porsbjerg C et al. Asthma. The Lancet. 2023.
17. 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.
18. 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.
19. Louis R et al. European Respiratory Society guidelines for the diagnosis of asthma in adults. European Respiratory Journal. 2022;60(3).
20. Gaillard EA et al. European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5-16 years. Eur Respir J. 2021;58(5):2004173.
21. 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.
22. Nolte H et al. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respiratory medicine. 2006;100(2):354-62.
23. Maspero J et al. Type 2 inflammation in asthma and other airway diseases. ERJ Open Research. 2022;8(3).