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Randomised controlled trials utilising FENO to manage asthma: is it time to acknowledge that “one size does not fit all”?

There have been several RCTs that have suggested that FENO-based algorithms, compared with usual guideline-based algorithms, significantly decrease asthma exacerbations [4–6], but universal use of FENO remains questionable [7]. Turner et al. [8] have recently reported a large multicentre RCT (RAACENO) that utilised FENO to guide treatment in children with asthma, but were unable to demonstrate a reduction asthma exacerbations. The current study by Murphy et al. [1] is another RCT reporting insignificant results for the use of FENO Murphy and co-workers provide further information on the tailoring of asthma treatment based on FENO for pregnant mothers and perinatal outcomes; however, a composite algorithm may be needed for RCTs utilising FENO https://bit.ly/3Bw1vO6