TY - JOUR T1 - Fluticasone propionate in clinically suspected asthma patients with negative methacholine challenge test JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 358 AU - Hamidreza Abtahi AU - Soheil Peiman Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/358.abstract N2 - 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 µg 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±3.3 to 20.8±3.2, P <0.001). Post treatment values of daytime (1.1±1.2) and night-time (0.5±0.1.0) NCS decreased compared to pretreatment values (2.9±1.2 and 1.7±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. ER -