Related Experiment Video
Updated: Jun 15, 2025
Murine Model of Allergen Induced Asthma
Published on: May 14, 2012
The Abbreviated Methacholine Challenge Test is Safe for Children
Avigdor Hevroni1, Shay Nemet2, Amit Ringel3
1Department of Pediatrics and the Pediatric Pulmonology and CF Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Pediatrics, Assuta Medical Center, Ashdod, Israel.
Objective:
To evaluate the safety of an abbreviated methacholine challenge test (MCT) protocol in children.
Study Design:
This prospective, observational study enrolled children aged 6 through 18 years referred for the MCT. The abbreviated protocol was initiated with a methacholine dose of 0.03 mg/ml and escalated in fourfold increments, unless the forced expiratory volume at 1 second decline exceeded 10%, at which point the next dose was only doubled. The safety of this abbreviated approach was assessed by monitoring adverse events, and specifically, decreases in forced expiratory volume at 1 second over 40%, hypoxemia, or uncontrollable cough. The number of methacholine doses and test duration were recorded and compared with estimated outcomes derived from the full-length MCT protocol.
Results:
One hundred twelve participants, aged 13.7 years (±3.3), successfully completed the protocol. Fifty-seven (51%) presented a positive MCT response. No significant clinical adverse events were observed. Of all participants, 2.7% exhibited an exaggerated response, in line with previously reported findings for the full-length protocol. The abbreviated approach resulted in an estimated average time-savings of 18:19 minutes per participant, thus reducing test length by 22:47 minutes for a negative MCT and by 14:34 minutes for a positive outcome.
Conclusions:
This abbreviated MCT protocol is safe for children and effectively shortens the duration of the MCT.
Insights
This study shows an abbreviated methacholine challenge test (MCT) is safe for children. The shortened protocol significantly reduces test time without compromising safety, making it a viable option for pediatric asthma evaluations.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Trials
Background:
- The methacholine challenge test (MCT) is a standard diagnostic tool for asthma.
- Traditional MCT protocols can be lengthy, potentially causing patient discomfort and logistical challenges.
- Evaluating shorter, safer protocols is crucial for improving pediatric respiratory diagnostics.
Purpose of the Study:
- To assess the safety and efficacy of an abbreviated methacholine challenge test (MCT) protocol in pediatric patients.
- To determine if a modified, shorter MCT protocol yields comparable safety outcomes to the standard protocol.
- To quantify the time savings associated with the abbreviated MCT.
Main Methods:
- A prospective, observational study involving 112 children aged 6-18 years undergoing MCT.
- Implementation of an abbreviated protocol with dose escalation adjustments based on forced expiratory volume at 1-second (FEV1) decline.
- Safety monitoring included adverse events, FEV1 decline >40%, hypoxemia, and cough; test duration and doses were recorded.
Main Results:
- The abbreviated MCT protocol was safely completed by all 112 participants.
- No significant clinical adverse events were observed; exaggerated responses occurred in 2.7% of participants, consistent with full-length protocols.
- The abbreviated protocol resulted in significant time savings, reducing overall test duration by an average of 14-22 minutes depending on test outcome.
Conclusions:
- The abbreviated methacholine challenge test (MCT) protocol is a safe and effective alternative for pediatric asthma diagnosis.
- This shortened protocol offers substantial time savings, enhancing patient experience and clinical efficiency.
- The findings support the adoption of this abbreviated MCT in pediatric respiratory assessments.
