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Asthma and Exhaled Nitric Oxide (eNO) A Simple, New Breath Test to Help Manage Asthma

Asthma is characterized by airway inflammation When airways get inflamed, the inner walls of the airway swell, so there is less space for a smooth flow of air. Inflammation of the airways leads symptoms such as shortness of breath, wheezing and coughing. The primary focus of asthma treatment is to reduce inflammation. Unfortunately, current methods of testing lung function do not measure inflammation. Therefore, you have to correlate symptoms to disease severity when prescribing or adjusting medication.

By courtesy of Encyclopaedia Britannica, Inc., copyright 2001; used with permission

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Simple breath tests are now available to measure eNO levels. Your patients simply breathe out steadily into a breath tube that is connected to the test device. The test itself takes just about 10 seconds. The results are available within one minute.

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Inflamed airways produce nitric oxide which becomes part of your breath. Exhaled nitric oxide has been studied well over the last 10 years. These studies have shown a strong relation between eNO and airway inflammation. Exhaled nitric oxide (eNO) increases as inflammation increases, and it decreases as inflammation decreases.

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Exhaled nitric oxide (eNO) provides a new way to measure inflammation

As airway inflammation increases, eNO increases.

(Level of Exhaled Nitric Oxide)

eNO

Regular monitoring of eNO provides a more complete picture of your asthma

Patient has high inflammation

Inflammation drops over time after treatment is adjusted

Time Illustration of therapy showing a reduction in inflammation by precise adjustment of medication

Adding eNO tests to other standard clinical measures gives you a better picture of your patients’ airway inflammation. This can help improve asthma control. By regularly monitoring your eNO levels, you can treat your patients’ asthma more precisely.


Answers to frequently asked questions Is eNO prescribed by specialists like pulmonologists and allergists? Exhaled nitric oxide (eNO) has been studied since 1991 when it was first reported in exhaled breath. There are numerous publications on eNO and its role in airway inflammation. It is currently being prescribed across the nation by physicians that specialize in respiratory care. The Insight™ eNO System has been commercially available since April 2008.

Has eNO been studied in children? Exhaled nitric oxide has been used as an endpoint and as an asthma assessment tool in numerous pediatric asthma studies. Its relationship to airway inflammation (the cause of asthma symptoms) has been established in both adults and children.

How is it different from a spirometer? A spirometer is an effective way to measure lung function, which correlates with symptoms being experienced at the time of testing. Exhaled nitric oxide is a marker of airway inflammation and reflects changes in disease state regardless of outward symptoms. Exhaled nitric oxide is the only non-invasive, practical and cost-effective way to regularly monitor patients’ degree of airway inflammation. It provides greater insight into their response to anti-inflammatory therapies like inhaled corticosteroids. And, unlike a spirometer measurement, an eNO result does not depend on patients’ “best effort”. Spirometry

eNO Testing

Measures lung function

Measures airway inflammation

Involves forced exhalation by the child in a very short duration of time

Involves steady exhalation by the child over a slightly longer duration of time

Test result is a complex waveform

Test result is a numerical value that has a direct correlation to the degree of inflammation of the airways

Is it an easy test for children to do? The Insight™ eNO test is short and easy – about 10 seconds – and requires only a small volume of exhaled air. Measurement of eNO provides reliable results that indicate a child’s degree of airway inflammation. It does not involve a high rate of energy expenditure from the child and it is an easy test to administer in the physician’s office.

Is eNO right for my practice? The Insight eNO System has received clearance from the FDA for use in clinic or a physician’s office to measure exhaled nitric oxide in children 8 years and older. Exhaled nitric oxide is a great addition to any practice that is looking to improve the management of asthma. Symptoms do not always accurately reflect the degree of inflammation in patients’ airways. Exhaled nitric oxide provides a clearer picture of your patients’ asthma by providing quantitative evidence for the degree of inflammation - information that was not available before. By knowing your patients’ degree of airway inflammation, you can now see how well they are responding to anti-inflammatory medication; whether they are adhering to the prescribed medication plan; and overall, improve the precision of your therapy.

Does eNO testing replace spirometry? No, measurement of exhaled nitric oxide is intended and approved to be used as an adjunct to current techniques for assessment of asthma. It is not intended to replace spirometry. Spirometry and eNO testing measure two different aspects of asthma.

How can I order a system? Call Apieron at 1-866-550-4eNO (1-866-550-4366) to arrange for a demonstration or to purchase or finance an Insight eNO System.

www.apieron.com Managing asthma is a breath away™

© 2008 Apieron, Inc. Insight™ is a trademark of Apieron, Inc. ML00030.A


Asthma and Exhaled Nitric Oxide (eNO) - A Simple, New Breath Test to Help Manage Asthma