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Signs and Symptoms of Chest Diseases: Cough |

Comparison of Clinical Characteristics and Responsiveness to Bronchodilator Between Cough Variant Asthma and Eosinophilic Bronchitis FREE TO VIEW

Fang Yi, MD; Lina Han; Baojuan Liu; Wei Luo, BA; Qiaoli Chen; KeFang Lai, PhD
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Guangzhou Institute of Respiratory Diseases, Guangzhou, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A550. doi:10.1016/j.chest.2016.02.574
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SESSION TITLE: Cough

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 08:30 AM - 09:30 AM

PURPOSE: To study the clinical characteristics, airway inflammation and the responsiveness to bronchodilator in patients with cough variant asthma (CVA) and eosinophilic bronchitis (EB).

METHODS: According to diagnostic algorithm of Chinese Cough Guideline, patients with EB or CVA were enrolled from February 2013 to February 2015. Clinical characteristics were recorded. Sputum induction, spirometry and cough challenge test were performed in all patients. Cough sensitivity was quantified by the value of capsaicin concentration induced 5 or more cough and expressed as logC5. All subjects received 10mg Bambuterol Hydrochloride tablets (treatment group) or placebo (control group) in a randomized manner. After 3 days treatment period, the remission rate were compared and the clinical characteristics, airway inflammation, cough sensitivity and lung function were subsequently analyzed.

RESULTS: A total of 89 patients with chronic cough were enrolled, among which 41 were CVA and 48 were EB. Age, cough duration, comorbidity of allergic rhinitis and sputum differentiation (NEU% and EOS%) were not statistically different between EB and CVA. The gender ratios (female%) and prevalence of nocturnal cough were higher in CVA than EB (75.8% vs 41.7%, 63.2% vs 39.6%, p<0.05 respectively), while the value of FEV1%, FEV1/FVC, MMEF% were lower than those of EB (92.7±11.1 vs 100.0±14.0, 79.2±9.0 vs 83.2±6.5, 62.2±21.8 vs 78.6±21.6, p<0.01 respectively). The efficiency of Bambuterol Hydrochloride was significantly higher than placebo in CVA (64.3% vs 7.7%, p<0.05) and EB (28.1% vs 9.5%, p<0.05). Also, the responsive rate of Bambuterol Hydrochloride in CVA was significantly higher than that of EB (64.3% vs 28.1%, p<0.01). When regarded the responsiveness to bronchodilator as diagnostic criteria of CVA, the sensitivity, specificity, positive predictive value, negative predictive value and positive likelihood ratio were 64.3%, 71.9%, 66.7%, 69.7, 2.3 respectively. The logC5 of bronchodilator responder was significantly higher than non-responder in EB group [2.4 (1.80-3.0) vs 1.54 (0.82-1.87), p<0.05].

CONCLUSIONS: The clinical characteristics and airway inflammation are similar in EB and CVA. Though bronchodilator is more effective in CVA than EB, treatment responsiveness to bronchodilator can not be used as a diagnostic criteria of CVA.

CLINICAL IMPLICATIONS: It should be reconsidered that responsiveness to bronchodilator was regarded as a diagnostic criteria of CVA.

DISCLOSURE: The following authors have nothing to disclose: Fang Yi, Lina Han, Baojuan Liu, Wei Luo, Qiaoli Chen, KeFang Lai

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