Methacholine challenge testing: safety of low starting FEV1. Asthma Clinical Research Network (ACRN)

Chest. 1997 Jul;112(1):53-6. doi: 10.1378/chest.112.1.53.


Study objective: The lower limit for the baseline value to initiate methacholine bronchial hyperresponsiveness testing has not been well established. Recommendations have varied from > 1 L to above 80% of predicted. The objective was to determine if an FEV1 < 60% predicted was acceptable.

Design: Retrospective analysis of challenges in 88 patients with a baseline FEV1 of < 60% predicted (mean=45.8%; range, 22 to 59%.

Setting: Academic institutions.

Results: There were only four individuals whose FEV1 did not return to > 90% of baseline following one poststudy beta2-agonist treatment. All four responded to a second treatment. There were no adverse sequelae following challenge in any individual. Neither age (up to 79 years) nor gender influenced outcome.

Conclusions: In chronic moderate to severe asthma, it appears that bronchial hyperresponsiveness testing can be safely performed even in those patients with a low baseline FEV1.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adrenergic beta-Agonists / therapeutic use
  • Aged
  • Asthma / diagnosis*
  • Asthma / physiopathology
  • Bronchial Hyperreactivity / diagnosis*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests* / adverse effects
  • Bronchoconstrictor Agents* / adverse effects
  • Female
  • Forced Expiratory Volume*
  • Humans
  • Male
  • Methacholine Chloride* / adverse effects
  • Middle Aged
  • Retrospective Studies
  • Safety


  • Adrenergic beta-Agonists
  • Bronchoconstrictor Agents
  • Methacholine Chloride