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Managing chronic cough due to asthma and NAEB in adults and adolescents: CHEST guideline and expert panel report

Chest Feb 21, 2020

Côté A, Russell RJ, Boulet LP, et al. - Whether and how non-invasive measurements of airway inflammation, incorporating induced sputum and fractional exhaled nitric oxide, have a role in the assessment of cough related to asthma, was investigated. Researchers also inquired about the best treatment for cough because of asthma or non-asthmatic eosinophilic bronchitis (NAEB). They analyzed randomized controlled trials and observational trials involving adults and adolescents > 12 years of age having a chronic cough attributable to asthma or NAEB, by performing three systematic reviews. They selected eligible studies from MEDLINE, CENTRAL, and SCOPUS. By applying the CHEST guideline methodology, guidelines were formed and voted upon. Weak evidence was gained for a specific benefit associated with the application of non-invasive biomarkers among patients with chronic cough because of asthma, as opposed to established guidelines for asthma therapies in general and the incorporation in some guidelines for the role of biomarkers of airway inflammation to guide management in severe disease. Cough in asthma or NAEB can be best treated with inhaled corticosteroids followed by leukotriene receptor antagonism. This guideline affords suggestions on the role of non-invasive measurements of airway inflammation and treatment for cough because of asthma or NAEB on the basis of available literature and unveiled knowledge gaps as well as areas for future investigation.
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