FeNO home monitoring: Clinical benefits and practicality

Evidence in scientific literature relates primarily to sporadic FeNO measurement in the doctor's office. What has not yet been investigated to the same extent is the additional benefit of FeNO monitoring by patients at home. In this regard, the FeNO@home study provides new, groundbreaking insights.⁵ It was conducted as a multicenter study in Germany and Italy. Asthma patients of varying severity were enrolled. Furthermore, the study tested how the Vivatmo me patient device from Bosch performs in everyday use. Starting with the first presentations at the ERS Congress 2024, the results will now gradually be published in renowned journals.

A major challenge in clinical asthma management is the lack of robust, objective, longitudinal data on the individual disease course. Cross-sectional data gathered at individual time points during practice visits may suffer from the inherent variability of asthma and therefore are not fully representative. As a consequence, diagnosis and treatment may not be appropriately adapted to the patient’s individual inflammatory profile. Thus, patients may receive inappropriate medication, such as inhaled corticosteroids (ICS) in unsuitable doses, or they may seem ineligible for certain biologics.

FeNO home monitoring helps to solve this problem: Compared to sporadic FeNO tests in the doctor’s office, continuous home monitoring provides additional advantages, as the course of inflammation creates a more holistic clinical picture. FeNO@home^5,7 has revealed recurring patterns of inflammation – characterized by FeNO variability, median, and extremes. Ideally, FeNO is recorded together with other context data to enable optimal analyses of the patterns and cause-effect relationships – for example in conjunction with symptoms, lung function parameters, infections, medication, or allergen exposure. Patients’ individual FeNO profiles can be used for trigger identification and clinical decision-making to optimize personalized asthma management. Evidence suggests that a treat-to-target approach adding FeNO to the management strategy can improve asthma control.⁶

There is only one system in the world that is approved for FeNO monitoring at home: Bosch Vivatmo me accompanied by the Vivatmo app. The patient device enables quick, easy, and non-invasive FeNO testing anywhere and at any time. FeNO values are transferred to the app via Bluetooth. In their digital asthma diary, patients can also document other relevant data such as symptoms, pollen count, or medication. The app’s monthly reports can be shared with doctors. In the FeNO@home study, doctors and patients confirmed the excellent usability, high adherence, and therapeutic benefits of Vivatmo me.⁷