budesonide--formoterol-fumarate-drug-combination and Cough

Whether cysteinyl-leukotriene receptor antagonists (LTRAs) have a similar antitussive effect to inhaled corticosteroids and long-acting β2-agonist (ICS/LABA), and that LTRA plus ICS/LABA is superior to LTRAs alone or ICS/LABA alone in treating cough variant asthma (CVA) remain unclear. This study aimed to investigate and compare the efficacy of montelukast alone, budesonide/formoterol alone and the combination of both in the treatment of CVA.. Ninety-nine CVA patients were assigned randomly in a 1:1:1 ratio to receive montelukast (M group: 10 mg, once daily), budesonide/formoterol (BF group: 160/4.5 μg, one puff, twice daily), or montelukast plus budesonide/formoterol (MBF group) for 8 weeks. The primary outcomes were changes in the cough visual analogue scale (VAS) score, daytime cough symptom score (CSS) and night-time CSS, and the secondary outcomes comprised changes in cough reflex sensitivity (CRS), the percentage of sputum eosinophils (sputum Eos%) and fractional exhaled nitric oxide (FeNO). CRS was presented with the lowest concentration of capsaicin that induced at least 5 coughs (C5). The repeated measure was used in data analysis.. Montelukast alone, budesonide/formoterol alone and a combination of both were effective in improving cough symptom, decreasing cough reflex sensitivity and alleviating eosinophilic airway inflammation in patients with CVA, and the antitussive effect and anti-eosinophilic airway inflammation were similar. Trial registration ClinicalTrials.gov, number NCT01404013.

Topics: Acetates; Administration, Inhalation; Adrenal Cortex Hormones; Antitussive Agents; Asthma; Budesonide; Budesonide, Formoterol Fumarate Drug Combination; Capsaicin; Cough; Cyclopropanes; Formoterol Fumarate; Humans; Inflammation; Leukotriene Antagonists; Quinolines; Sulfides

Patients undergoing pulmonary resection often suffer from a dry, hacking cough, which is usually refractory to opioid cough suppressors such as codeine. The cough is often painful and impairs the quality of life of the patients. The efficacy of an inhaled corticosteroid plus β2-agonist against the persistent cough after pulmonary resection was evaluated in this study.. We enrolled 21 patients in this prospective study of the efficacy of an inhaled corticosteroid plus β2-agonist against persistent cough following pulmonary resection. After baseline evaluation of the severity of the postoperative persistent cough using a visual analog scale (VAS), treatment with an inhaled corticosteroid plus β2-agonist was initiated and continued for 2 weeks. At the end of the 2 weeks, the cough severity was evaluated again using a VAS.. The median grade of cough on the VAS before the start of the inhaled treatment was 4 (range 3-8). At the end of 2 weeks of treatment with an inhaled corticosteroid plus β2 agonist, the median grade of cough on the VAS decreased from 4 to 1 (range 0-4). As an adverse effect of the inhalation, hoarseness was observed in one patient, which disappeared promptly after discontinuing the inhalations.. Treatment with an inhaled corticosteroid plus β2 agonist appeared to be highly effective, without severe adverse effects, against the persistent cough suffered by patients after pulmonary resection.

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adrenergic beta-2 Receptor Agonists; Aged; Albuterol; Androstadienes; Antitussive Agents; Budesonide; Budesonide, Formoterol Fumarate Drug Combination; Chi-Square Distribution; Cough; Drug Combinations; Ethanolamines; Female; Fluticasone-Salmeterol Drug Combination; Formoterol Fumarate; Humans; Japan; Male; Middle Aged; Pneumonectomy; Prospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome