When do you test for asthma?
Asthma symptoms and lung function don’t tell the whole story. Complete a bronchoprovocation test.
Asthma symptoms can overlap with multiple other conditions – making objective testing essential for an accurate diagnosis.
Why order a methacholine challenge with Provocholine®?
Asthma shares symptoms with many other disease states but requires different treatment. Misdiagnosis leads to ineffective therapies, unnecessary expense, exposure to side effects of useless medication and delayed care.
Common Symptoms,
Alternative Causes
- Wheeze → vocal cord dysfunction or allergies
- Shortness of breath → cardiac in origin
- Cough → GERD or a viral infection
Research shows up to 33% of physician diagnosed asthma patients did not have asthma when re-evaluated with objective testing.1
Airway Hyperresponsiveness: A Hallmark of Asthma
Asthma shares symptoms with many other disease states but requires different treatment. Misdiagnosis leads to ineffective therapies, unnecessary expense, exposure to side effects of useless medication and delayed care.
- Confirm or rule out asthma
- Avoid unnecessary treatment
- Identify alternative diagnoses sooner
Symptomatic patients may have normal pre and post bronchodilator spirometry and still have asthma.2 Bronchoprovocation testing is used when asthma is suspected but spirometry is normal or near normal.
Bronchodilator responsiveness alone has moderate sensitivity and specificity and should not be used as a standalone diagnostic tool.3
How can we help?
Indication: Provocholine, a cholinergic agonist used in a methacholine challenge test, is indicated for the diagnosis of bronchial airway hyperreactivity in adults and pediatric patients five years of age and older who do not have clinically apparent asthma.
WARNING: SEVERE BRONCHOCONSTRICTION
WARNING: SEVERE BRONCHOCONSTRICTION See full prescribing information for complete boxed warning. • Severe bronchoconstriction can result from Provocholine administration (including the lowest dose) (5.1) • Use of Provocholine is contraindicated in pediatric and adult patients with baseline FEV1 < 60% predicted or adults with FEV1 < 1.5 L (5.1) • Use of Provocholine is not recommended in patients with clinically apparent asthma or wheezing (5.1) • If severe bronchoconstriction occurs, reverse immediately with a rapid-acting inhaled bronchodilator agent (β-Agonist) (5.1)
1. Aaron et al. Reevaluation of Diagnosis in Adults with Physician-Diagnosed Asthma. JAMA. 2017;317(3):269-279.
2. Boulet L-P, Boulay M-È, Côté A, et al. Airway inflammation and hyperresponsiveness in subjects with respiratory symptoms and normal spirometry. Eur Respir J 2022
3. Erbay, M., Ayçiçek, O., Hocek, A.B. et al. The diagnostic value of bronchodilator response in differentiating asthma, COPD, and ACO in fixed airflow obstruction: a retrospective study. BMC Pulm Med 25, 291 (2025)
