Researchers conducted a study to explore the fractional exhaled nitric oxide and Asthma treatment adherence among people who have asthma. Increased clinician awareness is available, but still, nonadherence to inhaled corticosteroid treatment presents a significant challenge to successful asthma management and risks inappropriate treatment escalation, particularly in severe disease. In asthmatic patients with Type-2 mediated biology, fractional exhaled nitric oxide (FeNO) has a role in assessing and monitoring adherence to inhaled corticosteroids.

Asthmatic patients with elevated FeNO are at an increased risk of exacerbation. High FeNO is often secondary to suboptimal adherence to inhaled corticosteroid treatment, whether intentional or nonintentional. FENO suppression can ‘unmask’ underlying adherence issues and is a valuable test in the presence of Type-2 biology in the ‘difficult-to-control asthma population. Identification of nonadherence can improve asthma control and prevent inappropriate commencement of costly biologic therapies.

The study concluded that the assessment of adherence and FeNO response to monitored inhaled corticosteroids in Type-2 biomarker high asthmatic individuals might prevent unnecessary escalation to biologic therapy. Establishing an ‘optimized’ FeNO may alert clinicians to the possibility of underlying nonadherence at future clinical assessments.

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Reference: https://journals.lww.com/co-allergy/Abstract/2021/02000/Fractional_exhaled_nitric_oxide_and_asthma.10.aspx