Comparison of methacholine chloride and methacholine bronchial provocation tests in clinical practice
Liu Shuyi, Xie Yanqing, Li Yun, Wang Zhufeng, Ye Peitao, Tan Lunfang, Gao Yi, Zheng Jinping
Abstract
ObjectiveTo compare the differences in diagnostic efficacy and safety in bronchial provocation test (BPT) between traditional activator methacholine and methacholine chloride, the first methacholine activator approved by the Green Channel of the State Food and Drug Administration for priority marketing for bronchial provocation test (BPT).
MethodsIn this single-centered cross-sectional study, the methacholine chloride BPT reports from September to November 2022 and the methacholine BPT reports from March 2017 to April 2022 were derived from the First Affiliated Hospital of Guangzhou Medical University.For adults (aged≥18 years old), 2 196 reports in methacholine chloride group and 23 729 reports in methacholine group were enrolled in the analysis.For children (aged 4-17 years old), 365 reports in the methacholine chloride group and 5 330 reports in methacholine group were enrolled in the analysis.A 1∶2 Propensity Score Match analysis was performed for both adult and child patients.Consequently, 2 196 reports in methacholine chloride group and 4 392 reports in methacholine group were enrolled in the analysis for adults, and 365 reports in the methacholine chloride group and 730 reports in methacholine group were enrolled in the analysis for children.The positive rate of BPT, airway hyperresponsiveness grades, diastolic drugs, and recovery time for positive patients and adverse reactions were compared between the methacholine group and methacholine chloride group.
ResultsAfter matching, the positive rate of BPT in methacholine chloride group and methacholine group were 25.77%(566/2 196) and 27.62%(1 213/4 391) respectively for adults, and 81.64%(298/365) and 80.82%(590/730) respectively for children.No significant difference was found in the positive rate of activator between the two groups in both adults and children (both P>0.05). No significant difference was found in airway hyperresponsiveness grades between the two groups in adults (P=0.341). No significant difference was observed in the diastolic drugs and recovery time for positive patients between the two groups in children (both P>0.05). Before matching, 6 patients reported very mild or mild adverse reactions in methacholine chloricle group, and 57 patients reported very mild or mild adverse reactions and only one moderate adverse reaction in methacholine group.
ConclusionsCompared to methacholine, methacholine chloride shows similar positive rate and recovery time, with good safety, suggesting it could be popularized in clinical practice.
Key words:
Asthma; Bronchial provocation tests; Methacholine chloride; Methacholine; Propensity score matching
Contributor Information
Liu Shuyi
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Xie Yanqing
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Li Yun
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Wang Zhufeng
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Ye Peitao
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Tan Lunfang
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Gao Yi
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
Zheng Jinping
The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
