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Cough Response to High-Dose Inhaled Corticosteroids in Patients with Chronic Cough and Fractional Exhaled Nitric Oxide Levels ≥ 25 ppb: A Prospective Study

  • Ji-Ho Lee,
  • Sung-Yoon Kang,
  • Iseul Yu,
  • Kyung Eun Park,
  • Ji-Yoon Oh,
  • Ji-Hyang Lee,
  • So-Young Park,
  • Min-Hye Kim,
  • Eun-Jung Jo,
  • Ji-Yong Moon,
  • Sae-Hoon Kim,
  • Sang-Hoon Kim,
  • Byung-Jae Lee,
  • Woo-Jung Song

摘要

This study aimed to investigate the effects of high-dose inhaled corticosteroids (ICS) on chronic cough patients with elevated fractional exhaled nitric oxide (FeNO) levels. In a prospective study, adults with chronic cough and FeNO ≥ 25 ppb, without any other apparent etiology, received fluticasone furoate (200 mcg) for three weeks. Outcomes were evaluated using FeNO levels, cough severity, and Leicester Cough Questionnaire (LCQ) before and after treatment. Of the fifty participants (average age: 58.4 years; 58% female), the treatment responder rate (≥ 1.3-point increase in LCQ) was 68%, with a significant improvement in cough and LCQ scores and FeNO levels post-treatment. However, improvements in cough did not significantly correlate with changes in FeNO levels. These findings support the guideline recommendations for a short-term ICS trial in adults with chronic cough and elevated FeNO levels, but the lack of correlations between FeNO levels and cough raises questions about their direct mechanistic link.