A Cross-sectional Study to Measure Cough in Severe Asthma
Research type
Research Study
Full title
A Cross-sectional Study to Measure Cough in Severe Asthma
IRAS ID
219046
Contact name
Liam Heaney
Contact email
Sponsor organisation
Queen's University Belfast
Duration of Study in the UK
2 years, 6 months, 0 days
Research summary
Patients with severe asthma are troubled with a variety of symptoms including chronic cough which when poorly controlled tend to drive treatment escalation. However, increasing the amount of treatment often fails to deliver adequate disease control and in the case of oral steroids, both patients and clinicians are well aware of the unacceptable side-effects of high dose therapy. To address this problem a novel approach to managing severe asthma based on stratifying patients and ultimately their treatment options according to their individual inflammatory biomarker profiles has gained widespread support. Measuring inflammation in airway and blood samples from asthmatics is now well established in clinical practice and it is apparent that only half of all patients with asthma have the typical eosinophilic airway inflammation driven by ‘Type 2’ cytokines (T2 cytokines: interleukin (IL)-4, IL-5, IL-13). In severe asthma, the proportion with T2-high disease appears to be even lower accounting for between 25 and 50% of patients. While T2-high asthma has been shown to respond well to steroid therapy, for the remainder of patients there is limited evidence that T2 cytokines play a major role. This has been termed ‘T2-low asthma’ and such patients show little or no response to steroid therapy. We have recently found that patients with severe asthma report a high degree of cough related morbidity and our preliminary evidence suggests that this is independent of T2 driven airway inflammation. Consequently, increasing the dose of steroids may not be an appropriate clinical response for some asthmatics with cough. Therefore, accurately defining how cough is related to the clinical and biological phenotypes in asthma is an important unmet clinical need.
REC name
HSC REC A
REC reference
17/NI/0051
Date of REC Opinion
6 Apr 2017
REC opinion
Further Information Favourable Opinion