PDF(Pubmed)
Abstract：
Cough is a common symptom in patients with chronic obstructive pulmonary disease (COPD). Patients with cough may exhibit various clinical characteristics and experience varying outcomes based on inhaled therapies they receive.
This study aimed to explore the clinical characteristics and outcomes of various inhaled therapies in COPD patients with frequent cough.
This was a multicenter, prospective cohort study. Of these patients, the median cough score in COPD assessment test (CAT) was two. Patients were classified into frequent cough group if they scored two or over in the first item of CAT and infrequent cough group otherwise. Patients with frequent cough were then divided into long-acting antimuscarinic (LAMA), long-acting beta2-agonist (LABA)/LAMA, inhaled corticosteroids (ICS)/LABA and ICS/LABA/LAMA groups. Minimum clinically important difference (MCID) (CAT scores decreased ≥2 from baseline) and the improvement of cough (cough score decreased ≥1 from baseline) were collected in the six-month follow-up. Frequent exacerbations (experiencing at least two exacerbations) were collected in the one-year follow-up.
Of 906 patients, 581 (64.1%) patients reported frequent cough at the initial visit. Frequent cough was associated with the current smokers and CAT scores (p < 0.05). The MCID showed no significant difference between frequent cough and infrequent cough groups in the follow-up. More patients with frequent cough experienced future frequent exacerbations compared to those with infrequent cough. After receiving inhaled therapies, 62% of patients with frequent cough got the cough improved. More patients with frequent cough treated with LABA/LAMA or ICS/LABA/LAMA attained MCID and fewer experienced exacerbations than those treated with LAMA or ICS/LABA (p < 0.05). The change in cough score showed no difference among various inhaled therapies in patients with frequent cough.
COPD patients with frequent cough were related to current smokers and higher CAT scores. These patients had a higher incidence of frequent exacerbations than those with infrequent cough. Patients with frequent cough who were treated with LABA/LAMA or ICS/LABA/LAMA were more likely to attain MCID and at a lower risk of exacerbation than those treated with LAMA or ICS/LABA.
This study aimed to explore the clinical characteristics and outcomes of various inhaled therapies in COPD patients with frequent cough.
This was a multicenter, prospective cohort study. Of these patients, the median cough score in COPD assessment test (CAT) was two. Patients were classified into frequent cough group if they scored two or over in the first item of CAT and infrequent cough group otherwise. Patients with frequent cough were then divided into long-acting antimuscarinic (LAMA), long-acting beta2-agonist (LABA)/LAMA, inhaled corticosteroids (ICS)/LABA and ICS/LABA/LAMA groups. Minimum clinically important difference (MCID) (CAT scores decreased ≥2 from baseline) and the improvement of cough (cough score decreased ≥1 from baseline) were collected in the six-month follow-up. Frequent exacerbations (experiencing at least two exacerbations) were collected in the one-year follow-up.
Of 906 patients, 581 (64.1%) patients reported frequent cough at the initial visit. Frequent cough was associated with the current smokers and CAT scores (p < 0.05). The MCID showed no significant difference between frequent cough and infrequent cough groups in the follow-up. More patients with frequent cough experienced future frequent exacerbations compared to those with infrequent cough. After receiving inhaled therapies, 62% of patients with frequent cough got the cough improved. More patients with frequent cough treated with LABA/LAMA or ICS/LABA/LAMA attained MCID and fewer experienced exacerbations than those treated with LAMA or ICS/LABA (p < 0.05). The change in cough score showed no difference among various inhaled therapies in patients with frequent cough.
COPD patients with frequent cough were related to current smokers and higher CAT scores. These patients had a higher incidence of frequent exacerbations than those with infrequent cough. Patients with frequent cough who were treated with LABA/LAMA or ICS/LABA/LAMA were more likely to attain MCID and at a lower risk of exacerbation than those treated with LAMA or ICS/LABA.
摘要：
■咳嗽是慢性阻塞性肺疾病（COPD）患者的常见症状。咳嗽患者可能表现出各种临床特征，并根据他们接受的吸入疗法经历不同的结果。
■本研究旨在探讨慢性阻塞性肺疾病频繁咳嗽患者的临床特征和各种吸入疗法的结果。
■这是一个多中心，前瞻性队列研究。在这些病人中,COPD评估测试(CAT)的中位咳嗽评分为2分.如果患者在CAT第一项中得分为2分或以上，则将其分为频繁咳嗽组，否则将其分为不频繁咳嗽组。然后将频繁咳嗽的患者分为长效抗毒蕈碱（LAMA），长效β2激动剂（LABA）/LAMA，吸入性皮质类固醇（ICS）/LABA和ICS/LABA/LAMA组。在六个月的随访中收集最小临床重要差异（MCID）（CAT评分从基线下降≥2）和咳嗽改善（咳嗽评分从基线下降≥1）。在一年的随访中收集了频繁的恶化(经历至少两次恶化)。
■在906名患者中，581例(64.1%)患者在初次就诊时报告频繁咳嗽。频繁咳嗽与当前吸烟者和CAT评分相关(p<0.05)。在随访中，经常咳嗽和不经常咳嗽组之间的MCID没有显着差异。与不经常咳嗽的患者相比，更多经常咳嗽的患者未来经常加重。在接受吸入治疗后，62%的频繁咳嗽患者咳嗽得到改善。与接受LAMA或ICS/LAMA治疗的患者相比，接受LABA/LAMA或ICS/LAMA治疗的频繁咳嗽患者更多获得了MCID，并且经历了更少的恶化（p<0.05）。咳嗽评分的变化在频繁咳嗽患者的各种吸入疗法中没有差异。
■经常咳嗽的COPD患者与当前吸烟者和较高CAT评分有关。与不经常咳嗽的患者相比，这些患者频繁加重的发生率更高。与接受LAMA或ICS/LAMA治疗的频繁咳嗽患者相比，接受LABA/LAMA或ICS/LAMA治疗的患者更有可能获得MCID，并且恶化的风险较低。
■本研究旨在探讨慢性阻塞性肺疾病频繁咳嗽患者的临床特征和各种吸入疗法的结果。
■这是一个多中心，前瞻性队列研究。在这些病人中,COPD评估测试(CAT)的中位咳嗽评分为2分.如果患者在CAT第一项中得分为2分或以上，则将其分为频繁咳嗽组，否则将其分为不频繁咳嗽组。然后将频繁咳嗽的患者分为长效抗毒蕈碱（LAMA），长效β2激动剂（LABA）/LAMA，吸入性皮质类固醇（ICS）/LABA和ICS/LABA/LAMA组。在六个月的随访中收集最小临床重要差异（MCID）（CAT评分从基线下降≥2）和咳嗽改善（咳嗽评分从基线下降≥1）。在一年的随访中收集了频繁的恶化(经历至少两次恶化)。
■在906名患者中，581例(64.1%)患者在初次就诊时报告频繁咳嗽。频繁咳嗽与当前吸烟者和CAT评分相关(p<0.05)。在随访中，经常咳嗽和不经常咳嗽组之间的MCID没有显着差异。与不经常咳嗽的患者相比，更多经常咳嗽的患者未来经常加重。在接受吸入治疗后，62%的频繁咳嗽患者咳嗽得到改善。与接受LAMA或ICS/LAMA治疗的患者相比，接受LABA/LAMA或ICS/LAMA治疗的频繁咳嗽患者更多获得了MCID，并且经历了更少的恶化（p<0.05）。咳嗽评分的变化在频繁咳嗽患者的各种吸入疗法中没有差异。
■经常咳嗽的COPD患者与当前吸烟者和较高CAT评分有关。与不经常咳嗽的患者相比，这些患者频繁加重的发生率更高。与接受LAMA或ICS/LAMA治疗的频繁咳嗽患者相比，接受LABA/LAMA或ICS/LAMA治疗的患者更有可能获得MCID，并且恶化的风险较低。
