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Asthma control predicted by ambulatory cough monitoring

Ambulatory cough frequency monitoring may help clinicians objectively measure levels of asthma control outside of asthma control questionnaires, according to recent research.

“Data from this study suggest objective measurements of cough provide unique information about asthma control, not fully captured by Asthma Control Questionnaire (ACQ) or Global Initiative for Asthma (GINA) questionnaires,” Paul A. Marsden, MD PhD, from the Centre for Respiratory Medicine and Allergy at the University of Manchester and Manchester Academic Health Science Centre in Manchester, United Kingdom, and colleagues wrote in their study. “Importantly cough frequency reflected asthma control independent of airflow obstruction and inflammation. The inclusion of measures of cough frequency in future asthma studies offers an objective measure of day to day control that may be better for assessing the impact of novel asthma therapies.”

Marsden and colleagues evaluated 89 patients (mean age 57 years; SD = ± 12 years old; 57% female) with asthma who underwent 24-hour ambulatory cough monitoring and tests such as exhaled nitric oxide, spirometry, methacholine challenge and sputum induction, as well as completed either GINA or ACQ, according to the abstract..

Eighteen patients (20.2%) were controlled, 39 patients (43.8%) were partly controlled and 32 patients (36%) were uncontrolled by GINA criteria, according to the abstract. Marsden and colleagues found a correlation between 24-hour cough frequency and ACQ-6 (r = 0.40; P < 0.001), as well as a higher median cough frequency (4.2 coughs/hour; range = 0.3-27.6) for patients with uncontrolled asthma compared with partially controlled asthma (1.8 coughs/hour; range = 0.2- 25.3; P = 0.01) and controlled asthma (1.7 coughs/hour; range = 0.3-6.7; P = 0.02) by GINA criteria.

According to multivariate analyses, factors such as increasing cough frequency and worsening forced expiratory volume in 1 second were associated with asthma control. The researchers noted no significant differences between airway inflammation measures across GINA or ACQ categories. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.