Fractional exhaled nitric oxide, methacholine, or forced expiratory flow between 25% and 75%

Nickels and Lim1 retrospectively evaluated 774 adults who underwent methacholine challenge and fractional exhaled nitric oxide (FeNO) measurement. They reported that approximately 16% of tested individuals had positive methacholine challenge results (ie, bronchial hyperreactivity [BHR]) and that FeNO values were higher in those with BHR. A receiver operating characteristic curve revealed an area under the curve of 0.57, suggesting a poor association between FeNO and methacholine outcomes. Therefore, the authors concluded that in corticosteroid-naive pulmonary patients with normal forced expiratory volume in 1 second values, FeNO poorly predicts the outcome of a methacholine challenge.

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