Important Safety Information | NIOX VERO® User Manual (PDF)
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An important benefit of measuring fractional exhaled nitric oxide (FeNO) is its ability to identify patients who are likely to benefit from treatment with corticosteroids.1
It has been shown that FeNO predicts the likelihood of corticosteroids responsiveness more consistently than spirometry, bronchodilator response, peak flow variation, or airway hyperresponsiveness to methacholine.2-4
For the management of patients with suspected or diagnosed asthma
FeNO-GUIDED THERAPY GOAL RANGE |
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FeNO levels and inflammation | |||
FeNO (ppb)* | LOW | INTERMEDIATE | HIGH |
Adults | <25 | 25-50 | >50 |
Children (<12 years) | <20 | 20-35 | >35 |
Th2-driven inflammation | Unlikely | Likely | Significant |
Diagnosis Considerations | |||
Interpretation with respect to steroid response |
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Guide to diagnosis |
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Monitoring (in patients with diagnosed asthma) | |||
Symptoms present |
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Symptoms absent |
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*Interpretations of levels based on patient having symptoms (cough and/or wheeze and/or shortness of breath) present during the past 6+ weeks. Smoking has been shown to reduce FeNO levels.5
References: 1. Dweik RA, Boggs PB, Erzurum SC, et al; on behalf of the American Thoracic Society Committee on Interpretation of Exhaled Nitric Oxide Levels (FeNO) for Clinical Applications. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. Am J Respir Crit Care Med. 2011;184:602-615. 2. Knuffman JE, Sorkness CA, Lemanske RF Jr, et al; for the Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute. Phenotypic predictors of long-term response to inhaled corticosteroid and leukotriene modifier therapies in pediatric asthma. J Allergy Clin Immunol. 2009;123:411-416. 3. Szefler SJ, Martin RJ, King TS, et al; for the Asthma Clinical Research Network of the National Heart, Lung, and Blood Institute. Significant variability in response to inhaled corticosteroids for persistent asthma. J Allergy Clin Immunol. 2002;109:410-418. 4. Smith AD, Cowen JO, Brassett KP, et al. Exhaled nitric oxide: a predictor of steroid response. Am J Respir Crit Care Med. 2005;172:453-459. 5. Persson MG, Zetterström O, Agrenius V, Ihre E, Gustafsson LE. Single-breath nitric oxide measurements in asthmatic patients and smokers. Lancet. 1994;343(8890):146-147. 6. Dweik RA, Boggs PB, Erzurum SC, et al. Supplement to: Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Application: an official ATS Clinical Practice Guideline Am JRespir Crit Care Med. doi:https://www.atsjournals.org/doi/suppl/10.1164/rccm.9120-11ST. Accessed May 8, 2020.