Tommy is a 15-year-old boy who had mild asthma and has been on low dose ICS for the past several years.
Visit 1 - • No symptoms
• Physical examination is normal
• The NIOX Value is 15 ppb
• Spirometry is normal
• There has been no signs or symptoms for more than six months
Question
• Has he outgrown his asthma?
• Or is he just well controlled on his low dose?
Interpretation
The NIOX Value indicates that Tommy presently has no eosinophilic airway inflammation.
Action
Tommy’s doctor suggests discontinuing his daily dose of steroids.
Tommy and his doctor decide that they should meet again after two months, but if he experiences any symptoms he should come back immediately.
• No symptoms
• Physical examination is normal
• The NIOX Value is now 17 ppb
Interpretation
There is only a small and non-significant increase of The NIOX Value and no signs of asthma relapse indicating Tommy has outgrown his asthma.
The doctor decides that Tommy should discontinue his ICS and come back in six months or give him a call if his symptoms recur.
Conclusion
The NIOX Value helped to safely discontinue ICS in a case where it was unclear whether or not the child had outgrown the asthma. If The NIOX Value had increased substantially, to over 50 ppb, that would have been an effective predictor of asthma relapse and Tommy should have been put back on ICS. However the fact that The NIOX Value did not increase, reassured the doctor that the correct decision was to withdraw the steroids.