Details

Autor(en) / Beteiligte

• Kanemitsu, Y
• Nishiyama, H
• Hara, J
• Fukumitsu, K
• Takeda, N
• Kurokawa, R
• Ito, K
• Tajiri, T
• Fukuda, S
• Uemura, T
• Ohkubo, H
• Maeno, K
• Ito, Y
• Oguri, T
• Takemura, M
• Niimi, A

Titel

P218 Bronchial thermoplasty improves cough hypersensitivity and cough in patients with severe asthma

Ist Teil von

• Thorax, 2023-11, Vol.78 (Suppl 4), p.A243-A244

Ort / Verlag

London: BMJ Publishing Group Ltd and British Thoracic Society

Erscheinungsjahr

2023

Beschreibungen/Notizen

• BackgroundCough is a troublesome symptom of asthma because it is associated with disease severity and poor asthma control. Bronchial thermoplasty (BT) may be effective in improving cough severity and cough-related quality of life in severe uncontrolled asthma.ObjectiveTo evaluate the efficacy of BT for cough in severe uncontrolled asthma.MethodsTwelve patients with severe uncontrolled asthma were enrolled in this study between 2018 May and March 2021 and arbitrarily divided into cough-predominant [cough severity Visual Analog Scale (VAS) ≥ 40 mm, n = 8] and typical asthma (cough VAS < 40 mm, n = 4) groups. Clinical parameters, such as capsaicin cough sensitivity [C-CS: the concentrations to inhaled capsaicin required to induce at least two (C2) and five (C5) coughs], lung function, and type-2-related biomarkers (fractional nitric oxides and absolute eosinophil counts) and cough-related indices [cough severity VAS and the Leicester Cough Questionnaire (LCQ)] were evaluated before and 3 months after performing BT.ResultsBT significantly improved both cough-related indices and C-CS in the cough-predominant group (table 1). Changes in C-CS were significantly correlated with changes in the LCQ scores (C5: r = 0.65, p = 0.02 for all patients, and r = 0.81, p = 0.01 for the cough-predominant group).There was an association between changes in C-CS with BT and improvement of cough-specific QoL without the influence of confounder, such as regular use of biologics and/or OCS or more impaired cough-specific QoL at enrollment.ConclusionsBT may be effective for cough in severe asthma by improving C-CS.Please refer to page A292 for declarations of interest related to this abstract.Abstract P218 Table 1Changes in clinical parameters with bronchial thermoplasty All patients (n = 12) Cough-predominant asthma (n = 8) Pre-BT Post-BT P value Pre BT Post BT P value ACT, points 13 (6) 16 (6) 0.03 11 (6) 15 (6) 0.03 AQLQ, points 4.0 (1.6) 4.7 (1.3) 0.16 3.9 (1.5) 4.7 (1.3) 0.30 LCQ, points 12.7 (5.1) 14.8 (2.7) 0.10 10.0 (3.7) 13.9 (2.4) 0.02 LCQ ≥1.3 after BT - 6 (50) - - 6 (75) - Cough VAS, mm 49 (32) 24 (23) 0.02 69 (16) 30 (28) 0.005 FeNO, ppb 22.7 (8.8) 19.4 (9.0) 0.12 22.3 (9.3) 17.2 (8.2) 0.054 AEC,/μL 19.9 (14.6) 86.5 (5.87) 0.06 11.8 (14.7) 121.9 (3.72) 0.04 Serum IgE, IU/mL 34.9 (5.4) - - 88.9 (7.14) - - C2, μM 2.30 (3.80) 6.16 (2.70) 0.04 2.43 (2.85) 8.21 (2.99) 0.03 C5, μM 3.07 (4.95) 6.51 (2.60) 0.16 2.66 (3.12) 8.21 (2.99) 0.04 Pre-bronchodilatorFEV1,%predicted 92.4 (19.9) 93.0 (19.2) 0.87 88.9 (21.9) 92.2 (19.7) 0.63 Post-bronchodilatorFEV1,%predicted 95.6 (17.6) 94.5 (17.2) 0.65 92.5 (19.4) 93.6 (18.9) 0.70 Reversibility,% 4.0 (5.1) 1.8 (3.5) 0.26 5.2 (5.6) 0.55 (2.5) 0.16 BT: bronchial thermoplasty, ACT: Asthma Control Test, AQLQ: Asthma Quality of Life Questionnaire, LCQ: Leicester Cough Questionnaire, FeNO: fractional nitric oxides, IgE: immunoglobulin E, AEC: absolute eosinophil count, FEV1: forced expiratory volume in 1 second.Transformed log values (AEC and serum IgE) were converted to geometric means (geometric SD). The remaining data were expressed as mean (SD).Serum IgE was measured only when enrolled patients.Transformed log values (AEC) were converted to geometric means (geometric SD). The remaining data were expressed as mean (SD).