Exhaled nitric oxide measurement is not useful for predicting the response to inhaled corticosteroids in subjects with chronic cough.

Full Abstract

BACKGROUND: Increased concentrations of exhaled nitric oxide (ENO) are identified predominantly in subjects with chronic cough due to conditions that habitually respond well to therapy with inhaled corticosteroids (ICSs). The aim of this study was to assess the usefulness of ENO in predicting the response to ICS therapy in subjects with chronic cough and to determine the relationship between either methacholine or adenosine 5'-monophosphate (AMP) responsiveness and the response to ICS therapy. METHODS: A total of 43 patients with chronic cough were studied. During the baseline period, ENO measurement, spirometry, and concentration-response studies with both methacholine and AMP were performed. For the next 4 weeks, the patients were treated with inhaled fluticasone propionate, 100 microg twice daily. At baseline (1 week) and during the 4-week treatment period, patients twice daily completed entries in a diary, in which they recorded daytime and nighttime cough symptom scores. RESULTS: Nineteen patients (44%) responded well to fluticasone therapy. The receiver operating characteristic curve analysis showed that the accuracy of identifying the response to ICS therapy for ENO at baseline was poor. The sensitivity and specificity of ENO for predicting the response to ICS therapy, using 20 parts per billion as the ENO cutoff point, were 53% and 63%, respectively. Differences in both prevalence and degree of airway responsiveness to either methacholine or AMP between fluticasone-responsive subjects and nonresponsive subjects were also not significant. CONCLUSIONS: Although a significant proportion of subjects with chronic cough respond well to ICS therapy, these patients cannot be identified by ENO levels or AMP responsiveness at baseline.

Author information

Author/s: Prieto, Luis (L); Ferrer, Anna (A); Ponce, Silvia (S); Palop, Julio (J); Marín, Julio (J);

Affiliation: Seccion de Alergologia, Hospital Universitario Dr Peset, 46017 Valencia, Spain. prieto_jes(-atsign-)gva.es

Journal and publication information

Publication Type: Journal Article

Journal: Chest (Chest), published in United States. (Language: eng)

Reference: 2009-Sep; vol 136 (issue 3) : pp 816-22

Dates: Created 2009/09/08; Completed 2009/10/08;

PMID: 19411296, status: MEDLINE (last retrieved date: 10/8/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Adenosine Monophosphate - pharmacology
Administration, Inhalation
Adolescent
Adult
Aged
Androstadienes - administration & dosage
Bronchial Provocation Tests
Bronchodilator Agents - administration & dosage
Chronic Disease
Cough - drug therapy
Female

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Androstadienes (0) ; Bronchodilator Agents (0) ; Nitric Oxide (10102-43-9) ; Adenosine Monophosphate (61-19-8) ; Methacholine Chloride (62-51-1) ; fluticasone (90566-53-3)

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