@article {Abtahi358, author = {Hamidreza Abtahi and Soheil Peiman}, title = {Fluticasone propionate in clinically suspected asthma patients with negative methacholine challenge test}, volume = {42}, number = {Suppl 57}, elocation-id = {358}, year = {2013}, publisher = {European Respiratory Society}, abstract = {Objective : Despite response to steroid inhaler in some clinically suspected asthma patients with negative methacholine challenge test (CSA/ MCT-), asthma treatment in these patients has not been prospectively studied. We studied the role of a course of inhaled fluticasone trial in CSA/ MCT- patients. Method : After a 2 week run-in period, CSA/ MCT- patients were treated with 12 weeks of Fluticasone inhaler 500 {\textmu}g BID. Pre- and post-treatment Asthma Control Test (ACT) and numeric cough score (NCS) were recorded. Results : 26 of 34 patients completed the study. Mean pretreatment ACT score (pACT) was significantly increased after treatment (15.5{\textpm}3.3 to 20.8{\textpm}3.2, P \<0.001). Post treatment values of daytime (1.1{\textpm}1.2) and night-time (0.5{\textpm}0.1.0) NCS decreased compared to pretreatment values (2.9{\textpm}1.2 and 1.7{\textpm}1.6 respectively; P \<0.001). ACT score change (ΔACT) was significantly greater in those with pACT \< 15 than in those >= 15 (P= 0.001; Fig 1). In patients with ΔACT\>5, wheeze disappeared and 66\% of them did not use bronchodilator for symptom. Conclusion : A significant portion of CSA/ MCT- patients respond to high dose fluticasone inhaler in terms of symptoms, wheeze disappearance and bronchodilator use. In view of its safety profile, we suggest a course of steroid inhaler trial especially in CSA/ MCT-patients with pretreatment ACT score \<15 until the more predictive means of treatment response become available.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/358}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/358.full.pdf}, journal = {European Respiratory Journal} }