Efficacy and predictors of response to inhaled corticosteroid treatment for chronic cough
Autor: | Ki-Suck Jung, Seung Hun Jang, Joo-Hee Kim, Sunghoon Park, Yong Il Hwang, Ji Young Hong |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Budesonide medicine.medical_specialty Pulmonology adrenal cortex hormones Fluticasone propionate 03 medical and health sciences 0302 clinical medicine cough Interquartile range Internal medicine Administration Inhalation Republic of Korea Eosinophilic Humans Medicine Adverse effect Glucocorticoids business.industry Middle Aged Bronchodilator Agents respiratory tract diseases Chronic cough Hoarse voice Chronic Disease treatment outcome Fluticasone Female Original Article 030211 gastroenterology & hepatology medicine.symptom business Airway medicine.drug |
Zdroj: | The Korean Journal of Internal Medicine, Vol 34, Iss 3, Pp 559-568 (2019) The Korean Journal of Internal Medicine |
ISSN: | 2005-6648 1226-3303 |
Popis: | 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). Conclusion 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. |
Databáze: | OpenAIRE |
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