PURPOSE:Rationale: Cough is the most common symptom for which patients in the U.S. seek medical treatment in ambulatory settings. This study evaluated topical intranasal therapies in the treatment of cough associated with rhinitis.
METHODS:Methods: A total of 266 patients ranging in age from 7 to 85 years with seasonal allergic (3%), nonallergic (65%), or mixed rhinitis (32%) were treated with open-label combinations of azelastine nasal spray, steroid nasal sprays, ipratropium nasal spray, or cromolyn nasal spray. The diagnosis of contributory cause of cough was based on personal history, physical exam, and previous medical evaluations. Median duration of cough was 7 years and the percentage of smokers was <1%. Cause(s) of cough were identified and outcomes were classified either as improved or unimproved.
RESULTS:Results: Of the 266 patients with rhinitis-associated cough, 72% improved with intranasal therapy. The most effective combination therapies were azelastine nasal spray with ipratropium and cromolyn sprays (157/216, 73%) and azelastine nasal spray and intranasal steroid sprays (19/25, 76%). The majority of patients treated with azelastine nasal spray and cromolyn sodium spray improved (57%) as did patients treated with azelastine nasal spray and ipratropium nasal spray (100%), although the numbers of patients in these groups was small (n<25).
CONCLUSION:Conclusions: Seventy-two percent of patients with rhinitis-associated chronic cough experienced improvement with intranasal therapy. The prevalence of nonallergic rhinitis in this population suggests that health care providers are successfully treating allergic causes of chronic cough, but not as readily recognizing and treating nonallergic rhinitis.
CLINICAL IMPLICATIONS:Chronic cough, due to both allergic and non-allergic causes of post nasal drip, can be adequately controlled with the use of a regimen of nasal rinses and sprays.
DISCLOSURE:Brian Levine, No Financial Disclosure Information; No Product/Research Disclosure Information