Methacholine challenge positivity and FEV1/FVC change at clinically determined follow-up.

Authors

Dongyu He, Lan Yang, Junyi Ke, Jiaxuan Wu, Weimin Li

Published in

Expert review of respiratory medicine. Sep 25, 2026. Epub Sep 25, 2026.

Abstract

We evaluated the exploratory association between methacholine challenge positivity and subsequent spirometric change.
This single-center retrospective longitudinal study included adults with an unambiguous baseline methacholine challenge result, forced expiratory volume in 1 second (FEV1) ≥80% predicted, and FEV1/forced vital capacity (FVC) ≥0.70. Outcomes were FEV1/FVC change and FEV1/FVC < 0.70 at the first qualifying examination ≥ 1 year later. Models adjusted for baseline FEV1/FVC and follow-up interval.
Of 36,167 eligible individuals, 1,092 (3.02%) had qualifying follow-up spirometry, including 133 with a positive methacholine challenge. Positivity was associated with greater FEV1/FVC decline (adjusted difference, -2.53% points; 95% confidence interval, -3.63 to -1.44). Marginally standardized probabilities of follow-up FEV1/FVC < 0.70 were 8.07% and 2.63% for positive and negative individuals, respectively. Weighting and lower-limit-of-normal analyses yielded associations in the same direction.
Among adults with clinically indicated follow-up spirometry, methacholine challenge positivity was associated with greater FEV1/FVC decline. Its independent prognostic value remains to be established.

PMID:
42788860
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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