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A Clinical and Structural Comparison of Industrial Methacholine and Provocholine
Section snippets
METHODS
Nineteen medicine residents and respiratory therapists agreed to participate in the study. Standard questionnaires were used to obtain information on demographics, cigarette smoking, respiratory symptoms, and physician-diagnosed lung disease.4 After randomization, each subject performed methacholine challenge testing, following the protocol of O'Connor,5 with either methacholine (Spectrum Chemical Manufacturer, Gardenia, Calif) or Provocholine (Roche Laboratory, Nutley, NJ). Forty-eight hours
RESULTS
The study group consisted of 8 women and 11 men, of whom 3(15.8 percent) were current smokers and 3(15.8 percent) were former smokers. The mean age for the group was 33.4 ± 6.8 years; 4 subjects were current asthmatics. The mean logslope with methacholine (–0.15) and with Provocholine (–0.25) did not differ (paired Student's t test, p=0.64). Excellent agreement was found between each subject's logslope with methacholine and with Provocholine (intraclass correlation coefficient rI=0.82, Fig 1).
DISCUSSION
The results of this study suggest that methacholine from industrial sources and Provocholine might be used interchangeably for clinical and research purposes. If cost were the only issue, industrial methacholine clearly would be the preferred agent as it is 30 times less expensive than Provocholine. The former's lack of FDA and United States Pharmacopeia approval, however, raises concerns about possible product impurities and lot variability. While we found no evidence of such problems, our
ACKNOWLEDGMENTS
The authors thank Dr. Vernon Anderson. Department of Biochemistry, Case Western Reserve, Cleveland, for his performance and interpretation of the proton beam nuclear magnetic resonance analysis of the two compounds.
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