Bronchial Hyperreactivity Clinical Trial
Official title:
Methacholine Challenge Testing: Comparison of FEV1 and IOS Parameters in Adult Asthma Patients
A classic methacholine challenge test is considered positive when forced expiratory volumen after one second (FEV1) decrease 20%. Impulse oscillometry (IOS) measures airway resistance and reactance, and seems more sensitive to changes in small airways. In adult asthma patients, we compare methacholine challenge test using both FEV1 and IOS.
Asthma is a common chronic disease that is characterized by a history of variable respiratory symptoms and variable expiratory airflow limitation, and usually associated with airway hyperresponsiveness (GINA). In general, FEV1 is used to test for airway hyperresponsiveness (AHR), and a 20% decrease after methacholine challenge is considered a positive test (Coates 2017; ERJ). There is increasing recognition that the small airways are involved in 40-80% of patients with asthma, and the function of these airways is overlooked (the "silent zone") when measuring FEV1, which mainly reflects the function of the central airways (Cottini M, J Allergy Clin Immunol Pract 2019; Cottini M, 2022; Postma 2019 Lancet Respir Med). Small airway dysfunction (SAD) can be assessed by IOS where pressure applied to the airways at a range of frequencies, and components of respiratory resistance and reactance are measured. Resistance at 5 Hz (R5) and 20 Hz (R20), respectively, represent total airway resistance and proximal airway resistance. The difference between these two values can be calculated (R5-R20). High R5-R20 and low reactance at 5 Hz (X5) indicate the presence of SAD. A recent study showed that patients with a negative methacholine test measured by FEV1 may report asthma-like symptoms and may have a positive test when measured by IOS (Urbankowski; 2021). The question is whether these patients are a subgroup of patients with SAD (based on IOS at baseline) or are characterized in another way. Knowledge on the proportion of patients with AHR only measured by IOS (not by FEV1) and the characteristics of these patients are sparse. Hypothesis & Aims The aim of the present study was to determine the proportion of AHR to methacholine measured by FEV1 and IOS, respectively, in patients with diagnosed asthma and to compare patient characteristics and asthma medication in these four groups of patients: 1) negative by FEV1 and IOS; 2) negative by FEV1 but positive by IOS; 3) positive by FEV1 but negative by IOS; 4) positive by both tests. ;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT06016244 -
Safe, Effective and Cost-Effective Oxygen Saturation Targets for Children and Adolescents With Respiratory Distress: a Randomized Controlled Trial
|
N/A | |
| Completed |
NCT01654588 -
Different End Points for Bronchial Hyperactivity (BHR) Tests.
|
N/A | |
| Completed |
NCT02343419 -
Diagnostic Utility of Different Airway Resistance Assessment Techniques in the Methacholine Challenge Test
|
N/A | |
| Completed |
NCT00916526 -
Measurement of Exhaled Nitric Oxide (NO) and Bronchial Provocation Test With Mannitol as a Predictor of Response to Inhaled Corticosteroids in Chronic Cough
|
N/A | |
| Recruiting |
NCT05618769 -
Towards Life-Long Healthy Lungs: A Multidisciplinary Follow-up Framework for Preterm Infants
|
N/A | |
| Completed |
NCT05821868 -
Contrasting Dosivent With Plus Flow Vu Spacer in Bronchial Hyperreactivity Participants
|
N/A | |
| Completed |
NCT00503659 -
Comparison of Two Methods of Bronchial Methacholine Provocation
|
N/A | |
| Not yet recruiting |
NCT04168554 -
Telemedicine in the Generals Practitioners Office
|
||
| Completed |
NCT00453765 -
The Effect of Montelukast in Patients With Chronic Cough and Bronchial Hyperreactivity
|
Phase 4 | |
| Terminated |
NCT00567463 -
Early Antiinflammatory Treatment of Asthma
|
N/A | |
| Completed |
NCT01269528 -
Prospective Evaluation of the Efficacy of Palivizumab Administration in Children Born at 29-32 Weeks of Gestation
|
N/A | |
| Completed |
NCT00519740 -
Influence of Nutrition on Nasal and Bronchial Affliction in Patients With Allergy on Grass-Pollen
|
N/A | |
| Recruiting |
NCT06110481 -
Reversibility of Bronchial Obstruction in Children Born Preterm
|