1. WAO-ARIA consensus on chronic cough – Part III
- Author
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Philip W. Rouadi, Samar A. Idriss, Jean Bousquet, Tanya M. Laidlaw, Cecilio R. Azar, Mona S. Al-Ahmad, Anahi Yañez, Maryam Ali Y. Al-Nesf, Talal M. Nsouli, Sami L. Bahna, Eliane Abou-Jaoude, Fares H. Zaitoun, Usamah M. Hadi, Peter W. Hellings, Glenis K. Scadding, Peter K. Smith, Mario Morais-Almeida, René Maximiliano Gómez, Sandra N. Gonzalez Diaz, Ludger Klimek, Georges S. Juvelekian, Moussa A. Riachy, Giorgio Walter Canonica, David Peden, Gary W.K. Wong, James Sublett, Jonathan A. Bernstein, Lianglu Wang, Luciana K. Tanno, Manana Chikhladze, Michael Levin, Yoon-Seok Chang, Bryan L. Martin, Luis Caraballo, Adnan Custovic, Jose Antonio Ortego-Martell, Olivia J.Ly Lesslar, Erika Jensen-Jarolim, Motohiro Ebisawa, Alessandro Fiocchi, Ignacio J. Ansotegui, Beirut Eye & ENT Specialist Hospital (BESH), Eye & Ear Hospital [Beirut], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Berlin Institute of Health (BIH), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Brigham and Women’s Hospital [Boston, MA], Harvard Medical School [Boston] (HMS), American University of Beirut Faculty of Medicine and Medical Center (AUB), Middle East Institute of Health, Clemenceau Medical Center (CMC), Kuwait University, Investigaciones en Alergia y Enfermedades Respiratorias (InAER), Hamad Medical Corporation [Doha, Qatar], International Cough Institute (ICI), Louisiana State University (LSU), LAU Medical Center-Rizk Hospital, University Hospitals Leuven [Leuven], Department of Microbiology, Immunology and Transplantation [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Ghent University Hospital, Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), The Royal National Throat, Nose and Ear Hospital, Griffith University [Brisbane], Hospital CUF Descobertas, Facultad de Ciencias de la Salud [Salta], Universidad Nacional de Salta (UNSA), Universidad Autonoma de Nuevo Leon [Mexique] (UANL), Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Saint George Hospital University Medical Center [UOB LIBAN], University of Balamand [Liban] (UOB), Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Humanitas Clinical and Research Center [Rozzano, Milan, Italy], UNC School of Medicine, The Chinese University of Hong Kong [Hong Kong], University of Louisville School of Medicine, University of Cincinnati College of Medicine, Peking Union Medical College Hospital [Beijing] (PUMCH), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Akaki Tsereteli State University, University of Cape Town, Seoul National University Bundang Hospital (SNUBH), The Ohio State University Wexner Medical Center., University of Cartagena, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, Universidad Autónoma del Estado de Hidalgo (UAEH), LifeSpan medicine, Medizinische Universität Wien = Medical University of Vienna, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University of Vienna [Vienna]-University of Vienna [Vienna]-Medical University Vienna, University of Vienna [Vienna]-University of Vienna [Vienna], Sagamihara National Hospital [Kanagawa, Japan], Bambino Gesù Children’s Hospital [Rome, Italy], Hospital Quirónsalud Bizkaia [Bilbao], and Salvy-Córdoba, Nathalie
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EXHALED NITRIC-OXIDE ,Pulmonary and Respiratory Medicine ,Cough specialty care ,Chronic cough management ,Allergy ,AIRWAY INFLAMMATION ,Upper airway cough syndrome ,Immunology ,MUCOSAL EOSINOPHILIC INFLAMMATION ,GASTROESOPHAGEAL-REFLUX DISEASE ,INHALED CORTICOSTEROIDS ,Lower airway disease ,Speech therapy ,QUALITY-OF-LIFE ,CHEST GUIDELINE ,Immunology and Allergy ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,Neuromodulators ,VARIANT ASTHMA ,Cough primary care ,Science & Technology ,CLINICAL-PRACTICE GUIDELINE ,Reflux cough ,REFRACTORY CHRONIC COUGH ,Life Sciences & Biomedicine ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology - Abstract
BACKGROUND: Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety. OBJECTIVES: The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed. OUTCOMES: This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough. ispartof: WORLD ALLERGY ORGANIZATION JOURNAL vol:15 issue:5 ispartof: location:United States status: published
- Published
- 2022