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Han, Jang, Kim, Park, Hwang, Kim, Kim, Hyun, and Jung: The Efficacy of Inhaled Corticosteroid on Chronic Idiopathic Cough
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(5): 422-429.

Published online: 30 November 2009

DOI: https://doi.org/10.4046/trd.2009.67.5.422

The Efficacy of Inhaled Corticosteroid on Chronic Idiopathic Cough

Boram Han, M.D.1, 2, Seung Hun Jang, M.D.1, 2, Yu Jin Kim, M.D.1, 2, Sunghoon Park, M.D.1, 2, Yong Il Hwang, M.D.1, 2, Dong-Gyu Kim, M.D.1, 2, Cheol-Hong Kim, M.D.1, 3, In-Gyu Hyun, M.D.1, 3, Ki-Suck Jung, M.D.1, 2

1Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.

2Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

3Division of Pulmonary, Allergy, and Critical Care Medicine, Hangang Sacred Heart Hospital, Seoul, Korea.

Address for correspondence: Seung Hun Jang, M.D. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 896, Pyeongan-dong, Dongan-gu, Anyang 431-070, Korea. Phone: 82-31-380-3718, Fax: 82-31-381-3973, chestor@hallym.or.kr

Received 24 August 2009       Accepted 24 September 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

The discomfort caused by chronic cough, that is persistent for more than 3 weeks, causes a number of patients to seek medical attention. However, the underlying disorder often remains undetermined despite thorough examinations, and is considered to be idiopathic. This study compared the efficacy of inhaled corticosteroid with conventional cough suppressants on chronic idiopathic cough.

Methods

Eligible patients with chronic idiopathic cough were randomly assigned to either the inhaled fluticasone group or the codeine plus levodropropizine oral administration group. The subjects in each group took their planned medication for 2 weeks. After the trial, comparative analyses of outcomes were performed in terms of the remnant cough (%) at the end of treatment, drug compliance, and adverse drug events.

Results

Seventy-seven patients were enrolled in this randomized trial; 38 to the inhaled fluticasone group and 39 to the codeine plus levodropropizine group. The remnant cough was 41.0±35.8% in the inhaled fluticasone group, and 32.4±32.0% in the codeine+levodropropizine group (p=0.288). Drug compliance was 95.4±7.4% and 81.8±18.6% in the inhaled fluticasone and the codeine+levodropropizine group, respectively (p<0.001). Nine patients had adverse drug events in the codeine+levodropropizine group compared to one in the inhaled fluticasone group (p<0.001).

Conclusion

Short-term inhaled corticosteroid is not inferior to conventional antitussive agents in controlling chronic idiopathic cough without significant adverse events.

Keywords: Cough, Antitussive Agents, Corticosteroid

Figures and Tables

Figure 1
Trial profile.
trd-67-422-g001
Figure 2
Remnant cough after two-week treatment. Remnant cough (% baseline) were 32.4±32.0% in the codeine+levodropropizine group and 41.0±35.8% in the fluticasone group (p=0.288). Dashed lines represent the mean.
trd-67-422-g002
Table 1
Baseline patient characteristics
trd-67-422-i001

Data are presented as mean±SD if they are not indicated.

*Rhinitis was defined when more than two symptoms of rhinorrhea, sneezing, nasal stuffiness, and itching sense were present at the time of enrollment.

Table 2
Clinical factors and remnant cough in each group
trd-67-422-i002
Table 3
Summary of adverse events
trd-67-422-i003

*One patient simultaneously had drowsiness and headache.

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