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Predictors for typical asthma onset from cough variant asthma
Masaki Fujimura1, Yoriko Nishizawa, Masaru Nishitsuji
1Respiratory Medicine, Cellular Transplantation Biology, Kanazawa Graduate University School of Medicine, Kanazawa, Japan. fujimura@med3.m.kanazawa-u.ac.jp
Summary
Cough variant asthma can progress to typical asthma. Bronchial hyperresponsiveness is identified as the key predictor for this progression, even in patients using inhaled corticosteroids.
Area of Science:
- Pulmonology
- Allergy and Immunology
Background:
- Cough variant asthma (CVA) is a precursor to typical asthma, with up to 30% of patients developing overt asthma symptoms.
- Predictors for the progression from CVA to typical asthma remain largely unknown.
Purpose of the Study:
- To identify predictors for the onset of typical asthma in patients initially diagnosed with cough variant asthma.
Main Methods:
- A cohort of 41 CVA patients underwent spirometry, bronchial reversibility testing, methacholine challenge, and eosinophil counts (blood and sputum).
- Patients were followed for a median of 4 years to identify typical asthma onset.
- Univariate and multivariate logistic regression analyses were used to determine significant predictors.
Main Results:
- Seven patients developed typical asthma during the follow-up period.
- Univariate analysis identified bronchial hyperresponsiveness, peripheral blood eosinophil count, and lack of inhaled corticosteroid (ICS) use as significant predictors.
- Multivariate analysis revealed bronchial hyperresponsiveness as the sole significant predictor (adjusted OR 0.028, p=0.0355).
Conclusions:
- Bronchial hyperresponsiveness is the most critical predictor for the risk of developing typical asthma in individuals with cough variant asthma.
- These findings aid in risk stratification and management of CVA patients.