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Cough Responds to Intranasal Therapies When Caused By Postnasal Drip: Presented at AAAAI

By Maggie Schwarz

PHILADELPHIA -- March 17, 2008 -- Cough associated with rhinitis and postnasal drip responds to intranasal therapies, according to research presented here at the Annual Meeting of the American Academy of Allergy, Asthma, & Immunology (AAAAI 2008).

Brian M. Levine, MD, Director, The Cough Center, Laguna Hills, California, evaluated several intranasal sprays (azelastine, steroids, ipratropium, and cromolyn) in 266 patients with rhinitis-associated cough.

Of the patients enrolled, 72% improved with intranasal therapy. Effective combination therapies used in the majority of patients were azelastine with ipratropium and cromolyn sprays (157/216, 73%), and azelastine and steroids (19/25, 76%). Treatment with azelastine and cromolyn was effective in 57% of patients, while azelastine and ipratropium were effective in 100% of patients, although the numbers of patients in these groups were small (n=25).

Dr. Levine pointed to the fact that cough is the most common symptom for which patients seek medical treatment in ambulatory settings, with more than 30 million office visits per year and the cost of treatment estimated at over $1 billion. He stressed that persistent cough can exert a profound effect on an individual's quality of life, work productivity, and overall emotional well-being.

Cough is categorised in terms of duration, with acute cough lasting less than 3 weeks, sub-acute cough lasting 3 to 8 weeks, and chronic cough lasting more than 8 weeks. The vast majority of patients are treated by primary care physicians, and in some cases, by specialists such as otolaryngologists, pulmonologists, or allergists. Most patients who present with cough have acute or sub-acute cases caused by infections, as well as postinfectious sequelae.

Dr. Levine reiterated that the majority of patients in his office-based study had chronic cough in association with rhinitis, and successful treatment of postnasal drip may explain the improvement in chronic cough with intranasal therapy. He said that the prevalence of nonallergic rhinitis in the study suggests that health care providers are treating allergic causes of chronic cough successfully, but not recognizing and treating nonallergic rhinitis as readily.

Funding for this study was provided by Meda Pharmaceuticals.


[Presentation title: Chronic Cough Caused By Postnasal Drip Responds To Intranasal Sprays. Abstract 506]

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