Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

Alyn H. Morice, Eva Millqvist, Maria G. Belvisi, Kristina Bieksiene, Surinder S. Birring, Kian Fan Chung, Roberto W. Dal Negro, Peter Dicpinigaitis, Ahmad Kantar, Lorcan P. McGarvey, Adalberto Pacheco, Raimundas Sakalauskas, Jaclyn A. Smith

Research output: Contribution to journalArticlepeer-review

279 Citations (Scopus)

Abstract

In 2011, a European Respiratory Society Task Force embarked on a process to determine the position and clinical relevance of the cough hypersensitivity syndrome, a disorder characterised by troublesome coughing often triggered by low levels of thermal, mechanical or chemical exposure, in the management of patients with chronic cough. A 21-component questionnaire was developed by an iterative process supported by a literature review. 44 key opinion leaders in respiratory medicine were selected and interviewed as to their opinions. There was a high degree of unanimity in the responses obtained, with all opinion leaders supporting the concept of cough hypersensitivity as a clinically useful paradigm. The classic stratification of cough into asthmatic, rhinitic and reflux-related phenotypes was supported. Significant disparity of opinion was seen in the response to two questions concerning the therapy of chronic cough. First, the role of acid suppression in reflux cough was questioned. Secondly, the opinion leaders were split as to whether a trial of oral steroids was indicated to establish a diagnosis of eosinophilic cough. The cough hypersensitivity syndrome was clearly endorsed by the opinion leaders as a valid and useful concept. They considered that support of patients with chronic cough was inadequate and the Task Force recommends that further work is urgently required in this neglected area.
Original languageEnglish
Pages (from-to)1132-1148
JournalEuropean Respiratory Journal
Volume44
Issue number5
Early online date19 Aug 2014
DOIs
Publication statusPublished - 01 Nov 2014

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