The FDA has approved Aridol (mannitol inhalation powder, from Pharmaxis) Bronchial Challenge Test Kit for the assessment of bronchial hyperresponsiveness in patients ≥6 years of age who do not have clinically apparent asthma. Aridol is a single-use, indirect test that requires patients to inhale increasing doses of dry powder mannitol from a hand-held device, which causes airways to narrow and contract when airway inflammation is present. The doses are contained in capsules that are administered at one-minute intervals until a positive response is achieved or until all the capsules have been inhaled, indicating a negative result.  A positive response is indicated when there is a 15% reduction in lung function from baseline compared to a 20% fall required by a methacholine challenge test. The lower the dose required to cause bronchoconstriction, the more severe the bronchial hyperresponsiveness. A positive Aridol test is complete in approximately 20 minutes, compared to an average of 44 minutes for a methacholine test.

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