Recorded live at the APAPP Conference in Las Vegas, Brian Bizik, MS, PA-C, DFAAPA, and Heather O’Connell, PA-C, discuss how FeNO testing and methacholine challenge testing can support asthma diagnosis and management when spirometry does not provide a clear answer. They explain how fractional exhaled nitric oxide, or FeNO, offers insight into type 2 airway inflammation and may help clinicians evaluate treatment response, inhaled corticosteroid use, and potential biologic therapy options.
The conversation also explores how methacholine challenge testing measures airway hyperresponsiveness and can help confirm or rule out asthma in patients with persistent symptoms but normal or inconclusive spirometry. Brian and Heather review appropriate patient selection, test interpretation, safety considerations, and how these two diagnostic tools can work together to identify different asthma phenotypes, avoid misdiagnosis, and guide more personalized treatment decisions.
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