Managing Chronic Cough Due to Asthma and NAEB in Adults and Adolescents: CHEST Expert Panel Report

Publication Date

2020

Journal Title

Chest

Abstract

© 2020 American College of Chest Physicians Background: Asthma and non-asthmatic eosinophilic bronchitis (NAEB) are among the commonest causes of chronic cough in adults. We sought to determine the role of non-invasive measurements of airway inflammation, including induced sputum and fractional exhaled nitric oxide, in the evaluation of cough associated with asthma, and what the best treatment is for cough due to asthma or NAEB. Methods: We undertook three systematic reviews of randomized controlled trials and observational trials of adults and adolescents > 12 years of age with a chronic cough due to asthma or NAEB. Eligible studies were identified in MEDLINE, CENTRAL, and SCOPUS and assessed for relevance and quality. Guidelines were developed and voted upon using CHEST guideline methodology. Results: Of the citations reviewed, 3/1,175, 53/656, and 6/134 were identified as being eligible for inclusion in the three systematic reviews, respectively. In contrast to established guidelines for asthma therapies in general and the inclusion in some guidelines for a role of biomarkers of airway inflammation to guide treatment in severe disease, the evidence of specific benefit related to the use of non-invasive biomarkers in patients with chronic cough due to asthma was weak. The best therapeutic option for cough in asthma or NAEB is inhaled corticosteroids followed by leukotriene receptor antagonism. Conclusions: This guideline offers recommendations on the role of non-invasive measurements of airway inflammation and treatment for cough due to asthma or NAEB based on the available literature, and identifies gaps in knowledge and areas for future research.

Volume Number

158

Issue Number

1

Pages

68 - 96

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Pulmonary, Critical Care, and Sleep Medicine

Additional Departments

Cardiovascular and Thoracic Surgery

PMID

31972181

DOI

10.1016/j.chest.2019.12.021

For the public and Northwell Health campuses

Share

COinS