According to a study published in The Korean Journal of Internal Medicine, short-course inhaled corticosteroid (ICS) therapy could reduce the cough frequency in patients with upper airway cough syndrome (UACS) and unexplained chronic cough (UCC) without significant adverse events. Duration of cough and cough resulting from cold air exposure were the clinical predictors of ICS response.
Researchers evaluated the efficacy and clinical predictors of ICS response in 101 patients with UACS (n= 68) or UCC (n=33) treated with fluticasone propionate (250 μg) or budesonide (400 μg) twice a day. Degree of persistent cough after a 2-week treatment (measured as 0-100% vs baseline), drug compliance, and adverse events were assessed.
After 2 weeks of ICS treatment, the median grade of persistent cough was 40% (interquartile range [IQR], 10-70) in UACS and 50% (IQR, 20-70) in UCC. A good response to a 2-week treatment, i.e. reduction in persistent cough grade by >50% was reported in 67.3% of all patients, and in 63.6% of patients with UACS and 67.6% of patients with UCC. After multivariate analysis, long duration of cough (≥52 weeks; P=.018) and cough not aggravated by cold air exposure (P=.031) were predictors of a poor response to short-course ICS treatment. A mild degree of husky voice was reported in 6 patients (UACS, 5; UCC, 1) receiving 2 weeks of ICS treatment. No other adverse events were reported and none of the patients discontinued treatment due to side-effects.
The authors said: “Extended treatment with ICS may be effective in patients with longer duration of cough. Further investigation is required to determine the optimal dose and duration of ICS in patients with UACS and UCC.”