Evidence map›Paper›PMID 40197695›Full record

ArticleMultidisciplinary respiratory medicine2025

The role of Fraction Exhaled Nitric Oxide (FeNO) in asthma management: an Italian consensus statement on clinical and economic aspects.

Matteo Bonini, Rosa Annibale, Simona Barbaglia, Marco Bo, Federica Capano, Mariagrazia Celeste, Pasquale Di Girolamo Faraone, Sabrina Ferri, Carlotta Galeone, Mario Picozza and 3 more

Abstract read
In one paragraph

Article in Multidisciplinary respiratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Matteo BoniniDepartment of Public Health and Infectious Diseases, Sapienza Università di Roma, Rome, Italy.
Rosa AnnibaleAzienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Italy.
Simona BarbagliaAssociazione Nazionale pazienti "Respiriamo Insieme-APS", Italy.
Marco BoAzienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano (Turin), Italy.
Federica CapanoAzienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano (Turin), Italy.
Mariagrazia CelesteFondazione Policlinico Tor Vergata, Rome, Italy.
Pasquale Di Girolamo FaraoneAzienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Italy.
Sabrina FerriFondazione Policlinico Tor Vergata, Rome, Italy.
Carlotta GaleoneBicocca Applied Statistics Center (B-ASC), Università degli Studi di Milano-Bicocca, Milan, Italy.
Mario PicozzaAssociazione FederAsma e Allergie, Italy.
Umberto RestelliLIUC - Università Cattaneo, Castellanza (VA), Italy.
Sofia SilvolaLIUC - Università Cattaneo, Castellanza (VA), Italy.
Fabio Luigi Massimo RicciardoloAzienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano (Turin), Italy; Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Turin, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic respiratory diseases cause significant global morbidity and mortality, with asthma being a major contributor. Globally, 461,000 asthma-related deaths and a prevalence of 262 million subjects were estimated in 2019. The objective of this paper is to summarize experts' opinions in the field of asthma to produce evidence on the clinical and economic impact of FeNO test in asthma management, as well as on its standard operational procedures.

methodsThe analysis conducted is based on a literature review of the FeNO test's role in asthma, focusing on its clinical and economic impact, strengths and limitations. Insights were gathered through interviews with ten Key Opinion Leaders in asthma management from various Italian regions. Their thoughts were summarized into key-messages and discussed in a joint meeting. A final document consolidating these discussions was outlined and approved by the experts involved.

resultsThe FeNO test is crucial in the clinical management of asthma, aiding in phenotypic classification and guiding therapeutic decisions, particularly in severe cases. The value of FeNO assessment is supported by extensive literature evidence and recommended by international guidelines. Moreover, published economic analyses highlight the sustainability of the initial investment in FeNO technology thanks to a reduction of short-term medical costs for National Health Services by decreasing hospital admissions, specialist visits, and exacerbations related to asthma management. The test should be conducted at the first visit at the asthma centre and then regularly during follow-ups to monitor therapy adherence, adjust treatments, and predict response to drugs. FeNO testing facilitates early detection of bronchial inflammation, shortening the time for patients to access appropriate therapy. Despite its ease of use, interpreting the results requires specialist oversight due to potential confounding factors.

conclusionsFeNO testing significantly improves asthma management by aiding in phenotyping, therapeutic strategy formulation, and monitoring. It enhances disease control, accelerates patient care, and offers economic benefits by reducing hospital admissions and treatment needs. However, practical and economic barriers can limit its adoption. Standardized test execution and result interpretation by specialists are essential for accurate patient management. The inclusion of FeNO assessment among exempt services for asthma patients would at last promote its equitable access.

Identifiers

PMID40197695
PMCPMC12047845

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