Source: Annual Congress 2002 - Aspects of respiratory disease in primary care
Disease area: Airway diseases

Abstract

Persistent cough may be associated with bronchial hyperresponsiveness and/or smoking. We analysed the baseline data of the participants of a general practice, single-centre, randomised, double-blind, placebo controlled parallel group study to determine the effect of a 2 weeks treatment with fluticasone propionate 2 x 250 mcg bd MDI via Volumatic spacer in patients with persistent cough (two weeks and over) and/or acute bronchitis (without asthma or COPD).
Participants: N=135, age range: 18-65y, women: 64%, bronchial hyperresponsive (PD20): 38%, allergy (RAST): 22%, smokers: 37% and FEV1% pred: mean 101%. Results: Mean FEV1 % pred in patients with normal PD20 was 107% and in patients with mild/moderate PD20 was 92% (p<0.001). Difference in PD20 between allergy y/n was small: median 1.80 mg (allergy) vs more than 2.00 mg histamine (no allergy) (p=0.011). There was no relationship between problems with environmental factors (AQLQ, Juniper) and PD20 measured in our patients, neither in smokers nor in non-smokers. Smokers of all ages had mean FEV1% pred lower than non-smokers (96% vs 105% pred, p=0.003). Baseline cough score (last 24 h) was weakly related (r=-0.21, p=0.02) to limitations by cough during the last 2 weeks. However, stronger relationships (r=-0.43 and r=–0,44, p<0.001) were found between baseline night-cough score (last 24 h) and awakenings by cough last night vs. interference (during the last 2 weeks) with getting a good night's sleep because of cough. Further results on the effect of fluticasone propionate will be presented.
In conclusion: Symptoms due to environmental factors do not predict hyperresponsiveness (PD20). FEV1%pred and problems with cough during the last night showed the strongest correlation with limitations due to persistent cough in primary care.

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B. B. P. Ponsioen, W. W. C. J. Hop, N. N. A. Vermue, A. A. M. Bohnen (Rotterdam, The Netherlands). Characteristics of adults with persistent cough in general practice. Eur Respir J 2002; 20: Suppl. 38, 2986

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