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Managing-Chronic-Cough-Due-to-Asthma-and-NAEB-in-A ...
Managing-Chronic-Cough-Due-to-Asthma-and-NAEB-in-A (1)
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The CHEST guideline and expert panel report addresses the management of chronic cough linked to asthma and non-asthmatic eosinophilic bronchitis (NAEB) in adults and adolescents. The report explores the utility of non-invasive airway inflammation measurements, like sputum analysis and fractional exhaled nitric oxide, in evaluating cough associated with asthma, as well as effective treatments. <strong>Background</strong>: Asthma and NAEB are leading causes of chronic cough in adults. While asthma is characterized by variable respiratory symptoms and airway limitation, NAEB involves similar eosinophilic airway inflammation but lacks typical asthma indicators like airway hyperresponsiveness. <strong>Findings and Recommendations</strong>: 1. <strong>Role of Non-Invasive Measures</strong>: Limited evidence suggests sputum eosinophil count and fractional exhaled nitric oxide can predict corticosteroid response in asthma-related cough. However, while biomarkers are useful for general asthma management, their specific role in chronic cough due to asthma is less clear. 2. <strong>Treatment for Asthma-Related Cough</strong>: Inhaled corticosteroids (ICS) are recommended as the first-line treatment for asthma-related cough. If symptoms persist, increasing ICS dosage or adding leukotriene inhibitors and beta-agonists can be considered. The evidence supports ICS as a primary treatment based on broader asthma management practices, despite limited cough-specific studies. 3. <strong>Treatment for NAEB-Related Cough</strong>: ICS is the recommended initial treatment for chronic cough due to NAEB. If symptoms don't improve, dosage increases and leukotriene inhibitors are suggested. The quality of existing studies on NAEB is low, leading to weaker recommendations. <strong>Conclusion and Future Research</strong>: The guideline provides general strategies for managing asthma or NAEB-related cough but underscores a significant gap in high-quality cough-specific research. Future studies should include cough as a critical outcome in asthma trials and evaluate novel therapies, including biologics, for better management of chronic cough related to these conditions.
Keywords
chronic cough
asthma
non-asthmatic eosinophilic bronchitis
sputum analysis
fractional exhaled nitric oxide
inhaled corticosteroids
leukotriene inhibitors
beta-agonists
biomarkers
airway inflammation
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