Tiotropium Attenuates Refractory Cough and Capsaicin Cough Reflex Sensitivity in Patients with Asthma

被引:43
|
作者
Fukumitsu, Kensuke [1 ]
Kanemitsu, Yoshihiro [1 ]
Asano, Takamitsu [1 ]
Takeda, Norihisa [1 ]
Ichikawa, Hiroya [1 ]
Yap, Jennifer Manes Go [1 ]
Fukuda, Satoshi [1 ]
Uemura, Takehiro [1 ]
Takakuwa, Osamu [1 ]
Ohkubo, Hirotsugu [1 ]
Maeno, Ken [1 ]
Ito, Yutaka [1 ]
Oguri, Tetsuya [1 ]
Nakamura, Atsushi [1 ]
Takemura, Masaya [1 ]
Niimi, Akio [1 ]
机构
[1] Nagoya City Univ, Grad Sch Med Sci, Dept Resp Med Allergy & Clin Immunol, Nagoya, Aichi, Japan
来源
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2018年 / 6卷 / 05期
关键词
Chronic asthmatic cough; Capsaicin cough reflex sensitivity; Tiotropium; Cough severity; Cough-specific quality of life; VARIANT ASTHMA; HEALTH-STATUS; AIRWAY; BRONCHOCONSTRICTION; EXPRESSION; MICE; INFLAMMATION; RECEPTORS; BROMIDE; THERAPY;
D O I
10.1016/j.jaip.2018.01.016
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Asthmatic cough is often refractory to standard treatments such as inhaled corticosteroids (ICS) and long-acting beta(2) agonists (LABA). Tiotropium may modulate cough reflex sensitivity of acute viral cough, but its efficacy in asthmatic cough remains unknown. OBJECTIVE: To evaluate whether tiotropium improves cough and cough reflex sensitivity in patients with asthma refractory to ICS/LABA. METHODS: Seventeen consecutive patients with asthma with chronic cough despite the use of ICS/LABA (13 women; 43.4 +/- 19.0 years; average ICS dose, 651 +/- 189 mu g/d; fluticasone equivalent) were additionally treated with tiotropium (5 mu g/d) for 4 to 8 weeks to examine its effects on pulmonary function and capsaicin cough reflex sensitivity (cough thresholds C2 and C5). Cough severity, cough-specific quality of life, and asthma control were also evaluated using cough visual analog scales (VASs), the Japanese version of Leicester Cough Questionnaire (J-LCQ), and Asthma Control Test (ACT), respectively. Patients with an improved cough VAS score of 15 mm or more were considered responders to tiotropium. RESULTS: Tiotropium significantly improved cough VAS, J-LCQ, and ACT scores, but not FEV1. Changes in cough VAS score correlated with those in C2 (r = -0.58; P = .03), C5 (r = -0.58; P = .03), and ACT scores (r = -0.62; P = .02), but not in FEV1 in the overall patients. When analyses were confined to the 11 responders, tiotropium significantly improved capsaicin cough reflex sensitivity within the subgroup (C2: P = .01 and C5: P = .02) and versus the nonresponders (C2: P = .004 and C5: P = .02). CONCLUSION: Tiotropium may alleviate asthmatic cough refractory to ICS/LABA by modulating cough reflex sensitivity but not through bronchodilation. (C) 2018 American Academy of Allergy, Asthma & Immunology.
引用
收藏
页码:1613 / +
页数:10
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