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Authors of a systematic review and meta-analysis published in Respiratory Investigation evaluated the efficacy of FeNO-guided asthma management in adults. The researchers included 13 randomized controlled trials with treatment durations of at least 12 weeks. Compared with conventional management, FeNO-guided strategies significantly reduced the number of participants experiencing one or more asthma exacerbations and the overall annual exacerbation rate. The researchers noted marginal improvements in asthma control questionnaire scores. However, there were no significant benefits for severe exacerbations requiring oral corticosteroids or hospitalization, lung function measures (FEV₁%), FeNO levels, or asthma-related QOL scores. Subgroup analysis indicated that both FeNO alone and FeNO combined with symptom scores effectively reduced exacerbations. The authors concluded that FeNO-guided management can reduce asthma exacerbations, though its broader impact on severe outcomes and QOL remains limited.