TUESDAY, Nov. 30, 2021 (HealthDay News) — Measurement of the fractional exhaled nitric oxide (FENO) is conditionally recommended for optimizing asthma treatment in patients in whom treatment is being considered, according to an official American Thoracic Society clinical practice guideline published online Nov. 15 in the American Journal of Respiratory and Critical Care Medicine.

Sumita B. Khatri, M.D., from the Cleveland Clinic, and colleagues examined the evidence to provide guidance of whether FENO testing is indicated to optimize asthma treatment for patients in whom treatment is being considered. Systematic reviews of published randomized controlled trials between 2004 and 2019 were performed, and recommendations were developed.

The researchers made a conditional recommendation for FENO-based care after considering the overall low quality of the evidence. FENO is suggested to be beneficial and should be used in addition to usual care in patients with asthma for whom treatment is being considered. This decision is based on the balance of effects that likely favor the intervention; moderate costs and resource availability, which probably favor the intervention; and the acceptability and feasibility of the intervention.

“The conditional recommendation means that there is some uncertainty that the desirable consequences of the intervention outweigh the undesirable consequences,” the authors write. “This decision means that most well-informed patients would choose FENO-based care but that a substantial minority of individuals with asthma may not desire this test and that the decision to conduct this test in an individual patient should be the result of an informed discussion between that individual and the provider.”

Several authors disclosed financial ties to the biopharmaceutical industry.

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