Effect of intranasal steroids on chronic cough caused by upper airway cough syndrome

ABSTRACT

PURPOSE: Although upper airway cough syndrome (UACS) is one of the most common causes of chronic cough, there are few reports on the effects of intranasal steroids (INS) on improvement of cough in patients with chronic cough caused by UACS. Here, we observed improvement in cough depending on prescribed medications, including INS, in patients with chronic cough caused exclusively by UACS in the clinical setting. METHODS: Patients with chronic cough caused exclusively by UACS were selected by the retrospective review of medical records. Durations and kinds of prescribed medications, nasal and postnasal drip symptoms, and results of paranasal sinus series at first visit were evaluated. According to the improvement of cough at the second visit, the patients were divided into the improved and unimproved groups. Odds ratios of each medication in the improved group were analyzed by logistic regression adjusted for age, sex, smoking history, duration of treatment, prescriptions of medications, presence of nasal and postnasal drip symptoms, and results of paranasal sinus series. RESULTS: A total of 122 patients with chronic cough caused exclusively by UACS were comprised of 38 patients in the improved group and 84 patients in the unimproved group. INS were prescribed to 45 patients, and the number of patients with INS prescription were significantly higher in the unimproved group than that in not-improved group (55.3% vs. 28.6%, P=0.008). The odds ratio of INS prescription was significantly higher in the improved group (odds ratio, 4.78; 95% confidence interval, 1.03-22.3; P=0.046). CONCLUSION: INS could improve cough symptom in patients with UACS. These results warrant further evaluation.