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Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough

BACKGROUND/AIMS: Inhaled corticosteroids (ICS) are a treatment of choice for eosinophilic airway diseases, but their efficacy for other causes of chronic cough is controversial. METHODS: We conducted a prospective observational study to determine the ICS efficacy and clinical predictors of response...

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Autores principales: Hong, Ji Young, Kim, Joo-Hee, Park, Sunghoon, Hwang, Yong Il, Jung, Ki-Suck, Jang, Seung Hun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506730/
https://www.ncbi.nlm.nih.gov/pubmed/30540903
http://dx.doi.org/10.3904/kjim.2017.291
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author Hong, Ji Young
Kim, Joo-Hee
Park, Sunghoon
Hwang, Yong Il
Jung, Ki-Suck
Jang, Seung Hun
author_facet Hong, Ji Young
Kim, Joo-Hee
Park, Sunghoon
Hwang, Yong Il
Jung, Ki-Suck
Jang, Seung Hun
author_sort Hong, Ji Young
collection PubMed
description BACKGROUND/AIMS: Inhaled corticosteroids (ICS) are a treatment of choice for eosinophilic airway diseases, but their efficacy for other causes of chronic cough is controversial. METHODS: We conducted a prospective observational study to determine the ICS efficacy and clinical predictors of response to ICS in patients with upper airway cough syndrome (UACS) or unexplained chronic cough (UCC). Sixty-eight patients with UACS and 33 patients with UCC (duration of cough ≥ 8 weeks) were treated with ICS: 250 µg of fluticasone propionate or 400 µg of budesonide twice a day at physician’s discretion. They were followed after 2 weeks to assess persistent cough which was measured as 0% to 100% compared with baseline cough frequency. RESULTS: The median grade of persistent cough after 2-week ICS treatment was 40% (interquartile range [IQR], 10 to 70) in UACS and was 50% (IQR, 20 to 70) in UCC. The only adverse event was infrequent, mild hoarse voice (five UACS and one UCC). Long duration of cough (≥ 52 weeks) and cough not aggravated by cold air exposure were predictors of a poorer response to short course ICS treatment (logistic regression analysis, p = 0.018 and p = 0.031, respectively). However, prolonged treatment with ICS more than 2 weeks was more effective in patients with long cough duration (≥ 52 weeks). CONCLUSIONS: Short course ICS treatment has modest efficacy on UACS and UCC without significant adverse events. Duration of cough and cough triggered by cold air exposure were the clinical factors associated with ICS response. Extended treatment with ICS may be beneficial in patients with long duration of cough.
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spelling pubmed-65067302019-05-20 Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough Hong, Ji Young Kim, Joo-Hee Park, Sunghoon Hwang, Yong Il Jung, Ki-Suck Jang, Seung Hun Korean J Intern Med Original Article BACKGROUND/AIMS: Inhaled corticosteroids (ICS) are a treatment of choice for eosinophilic airway diseases, but their efficacy for other causes of chronic cough is controversial. METHODS: We conducted a prospective observational study to determine the ICS efficacy and clinical predictors of response to ICS in patients with upper airway cough syndrome (UACS) or unexplained chronic cough (UCC). Sixty-eight patients with UACS and 33 patients with UCC (duration of cough ≥ 8 weeks) were treated with ICS: 250 µg of fluticasone propionate or 400 µg of budesonide twice a day at physician’s discretion. They were followed after 2 weeks to assess persistent cough which was measured as 0% to 100% compared with baseline cough frequency. RESULTS: The median grade of persistent cough after 2-week ICS treatment was 40% (interquartile range [IQR], 10 to 70) in UACS and was 50% (IQR, 20 to 70) in UCC. The only adverse event was infrequent, mild hoarse voice (five UACS and one UCC). Long duration of cough (≥ 52 weeks) and cough not aggravated by cold air exposure were predictors of a poorer response to short course ICS treatment (logistic regression analysis, p = 0.018 and p = 0.031, respectively). However, prolonged treatment with ICS more than 2 weeks was more effective in patients with long cough duration (≥ 52 weeks). CONCLUSIONS: Short course ICS treatment has modest efficacy on UACS and UCC without significant adverse events. Duration of cough and cough triggered by cold air exposure were the clinical factors associated with ICS response. Extended treatment with ICS may be beneficial in patients with long duration of cough. The Korean Association of Internal Medicine 2019-05 2018-12-13 /pmc/articles/PMC6506730/ /pubmed/30540903 http://dx.doi.org/10.3904/kjim.2017.291 Text en Copyright © 2019 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hong, Ji Young
Kim, Joo-Hee
Park, Sunghoon
Hwang, Yong Il
Jung, Ki-Suck
Jang, Seung Hun
Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title_full Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title_fullStr Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title_full_unstemmed Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title_short Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
title_sort efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506730/
https://www.ncbi.nlm.nih.gov/pubmed/30540903
http://dx.doi.org/10.3904/kjim.2017.291
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