The NIOX Value changes rapidly depending on anti-inflammatory treatment intake or allergen exposure (Silkoff 2004, Sorkness 2007, Piancentini 1999) . Inflammation measurement provides an easy to use and non-invasive tool for monitoring adherence to steroid treatment and allergen avoidance programs.
Elevated NIOX Values in patients taking maintenance doses of inhaled steroids determines whether or not the patient is adhering to the therapyprescribed (Delgado-Colcoran 2004) ,has a poor inhalation technique, is still exposed to allergens or has been prescribed enough anti-inflammatory therapy. Only rarely will an asthma patient be truly steroid resistant if The NIOX Value was high prior to treatment (Stirling 1998, Payne 2001) .
An active dialogue with the patient, discussing The NIOX Value and treatment recommendations improves the patient’s understanding on how the inflammation reacts to therapy/no therapy and increases compliance.
The NIOX Value correlates with poor, moderate or good compliance with corticosteroid treatment (Delgado-Corcoran 2004) .
Silkoff PE, et al. The Aerocrine exhaled nitric oxide monitoring system NIOX is cleared by the US Food and Drug Administration for monitoring therapy in asthma. J Allergy Clin Immunol 2004;114:1241-56.
Sorkness CA, Lemanske RF, Jr., Mauger DT, et al. Long-term comparison of 3 controller regimens for mild-moderate persistent childhood asthma: The Pediatric Asthma Controller Trial. J Allergy Clin Immunol 2007; 119: 64-72.
Piacentini GL, Bodini A, Costella S, et al. Allergen avoidance is as sociated with a fall in exhaled nitric oxide in asthmatic children. J Allergy Clin Immunol 1999;104:1323-4.
Delgado-Corcoran C, Kissoon N, Murphy SP, Duckworth LJ. Exhaled nitric oxide reflects asthma severity and asthma control. Pediatr Crit Care Med 2004 Vol.5, No.1.
Stirling RG, Kharitonov SA, Campbell D, et al. Increase in exhaled nitric oxide levels in patients with difficult asthma and correlation with symptoms and disease severity despite treatment with oral and inhaled corticosteroids. Asthma and Allergy Group. Thorax 1998;53:1030-4.
Payne DN, Wilson NM, James A, Hablas H, Agrafioti C, Bush A. Evidence for different subgroups of difficult asthma in children.Thorax 2001;56:345-50.