Nitric oxide tests to diagnose and treat asthma
8th November 2013 - New draft guidance recommending the use of simple, non-invasive tests to help diagnose and treat asthma have been produced by NICE, the National Institute for Health and Care Excellence.
The draft guidance, which is now available for public consultation, recommends three devices used for measuring the concentration of nitric oxide in a person’s breath. They work by analysing a breath sample using an electrochemical sensor.
Asthma is a chronic inflammatory condition which affects the lungs and causes shortness of breath, coughing, chest tightness and wheezing. It's estimated at least 5.4 million people in the UK have the condition.
Levels of nitric oxide, a gas produced as a result of inflammation in the lungs, are higher in people with asthma.
The draft NICE guidance recommends the tests NIOX MINO, NIOX VERO and NObreath to assist with the diagnosis of a type of asthma called eosinophilic asthma, caused by airway inflammation with an accumulation of eosinophils, a type of white blood cell.
The tests are also recommended to support the management of asthma in people whose symptoms are being treated with inhaled corticosteroids.
Exhaled nitric oxide
Exhaled nitric oxide concentration (called fractional exhaled nitric oxide or “FeNO”) has been shown to be elevated in patients with eosinophilic asthma and effective treatment with corticosteroids reduces symptoms and the level of FeNO.
In people already diagnosed with asthma, changes in FeNO levels can indicate how well they are responding to treatment with corticosteroids, and whether they are taking their medication as prescribed.
Research suggests that as many as 30% of people do not take their medication to control their asthma.
Professor Carole Longson, NICE Health Technology Evaluation Centre director, says in a press release that NICE "heard from a patient expert that FeNO-guided management could result in the patients better understanding their own disease and disease progression and make them more willing to accept the need for anti-inflammatory treatment to control their asthma."
Emily Humphreys, Asthma UK Head of Policy & Public Affairs told us via email: "Measuring the concentration of nitric oxide in someone’s breath has been shown to help ensure people with asthma are taking the right treatments. We hope that monitoring fractional exhaled nitric oxide (FeNO) will give healthcare professionals another useful tool to provide people with asthma the right medicines and advice.
"We are pleased with this draft NICE guidance and its positive recommendation, and we are keen to see it finalised and put into practice soon."