NICE recommends non-invasive tests for asthma

Support for three devices used for measuring the concentration of nitric oxide in patients' breath

Bedfont Nobreath is one of three tests being recommended in draft NICE guidance

New draft guidance recommending the use of non-invasive tests to help diagnose and treat asthma has been produced by the National Institute for Health and Care Excellence (NICE).

The document, 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.

The technology is said to mark a breakthrough in the treatment of asthma, a chronic inflammatory condition that affects the lungs, causing shortness of breath, coughing, chest tightness and wheezing. It is estimated to affect at least 5.4 million people in the UK alone.

The draft NICE guidance recommends the tests NIOX MINO, NIOX VERO and Bedfont NObreath to assist with the diagnosis of a particular type of asthma known as eosinophilic asthma, which is caused by airway inflammation from 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.

Levels of nitric oxide, a gas produced as a result of inflammation in the lungs, are known to be higher in people with asthma.

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.

We hope that monitoring fractional exhaled nitric oxide will give healthcare professionals another useful tool to provide people with asthma the right medicines and advice

Professor Carole Longson, NICE Health Technology Evaluation Centre director, said: "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, head of policy and public affairs at Asthma UK, added: "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 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."

Bedfont NObreath is manufactured by Bedfont Scientific and features a battery-powered monitor which has been specifically designed to be highly portable.

Jason Smith, commercial manager at Bedfont Scientific, said “The NObreath monitor enables doctors, asthma specialists, GPs and respiratory specialists to comply with ATS and ERS guidelines when testing for FeNO levels in asthma patients. Asthma patients can easily be tested and correctly assessed, thus saving time and reducing costs.”

NIOX MINO and NIOX VERO are manufactured by Aerocrine. Its chief executive, Scott Myers, said: “Aerocrine is very pleased with the preliminary recommendations by NICE. We have found the process very thorough and collaborative and we look forward to more doctors and patients gaining access to this leading edge method of managing airway inflammation.”

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