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Background: To compare peramivir 300 mg single‐dose, peramivir 600 mg repeat‐dose, and oseltamivir effects on health‐related quality of life, including respiratory symptoms and general conditions, time to symptom alleviation, time to fever resolution, incidence of exacerbations, and virus titer, in influenza patients with chronic respiratory disease. Methods: We report additional outcomes from a 2‐week, multicenter, randomized, open‐label study in Japan (UMIN000030118). Influenza patients with chronic respiratory disease received intravenous peramivir (300 mg single‐dose [n = 66], 600 mg repeat‐dose [600 mg/d of 2 consecutive days; n = 70]) or oral oseltamivir (75 mg twice daily, 5 days; n = 72). The principal endpoint of this analysis was change from baseline to Day 14 at each time point in Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scores. Results: Both peramivir regimens reduced total CAT score at Day 3 more than oseltamivir (peramivir 600 mg vs oseltamivir, P =.0032; peramivir 300 mg vs oseltamivir, P =.0203). Cough/phlegm CAT scores were most improved with peramivir 600 mg. Median time to alleviation of three respiratory symptoms was longer with peramivir 600 mg (68.9 hours) than with peramivir 300 mg (50.6 hours, hazard ratio [HR] 1.57; P =.0191) and shorter with peramivir 300 mg than oseltamivir (78.8 hours, HR 0.62; P =.0141). Alleviation of seven influenza symptoms and fever resolution was shortest with peramivir 300 mg. Conclusions: Rapid improvement in CAT score, including cough, and shorter time to alleviation of respiratory symptoms associated with peramivir is of potential benefit to patients with chronic respiratory disease. [ABSTRACT FROM AUTHOR]

Background and objective: It has yet to be determined whether the presence of productive cough is a risk factor for the development of COPD. The aim of the present study was to obtain more information on this potential association in Japanese men. Methods: Seven hundred and eighty-three men with normal spirometry who did not have respiratory disease were recruited. The subjects were divided into three groups: group A, non-smokers; group B, those with a positive smoking history without productive cough; and group C, those with a positive smoking history and productive cough. The incidence rates of COPD were compared among the three groups and the relative risks for the development of COPD were assessed. Results: During the mean follow-up period of 33.6 ± 20.4 months, 19 (2.4%) subjects developed COPD. The incidence rate of COPD was significantly higher in group C than in group B (10.1 vs 2.2%, P = 0.003). A multivariate analysis of data for all subjects, current smokers and former smokers revealed that productive cough was an independent risk factor for the development of COPD in all subjects and former smokers but not in current smokers. Conclusions: Productive cough was an independent risk factor for the development of COPD in Japanese men. In particular, former smokers who complain of this symptom should be regarded as being at high risk for the development of COPD. The data suggested that stage 0 disease, as defined in the Global Initiative for Chronic Obstructive Lung Disease 2001 guidelines, is relevant for the identification of subjects at risk of developing COPD. [ABSTRACT FROM AUTHOR]

Prevalence and clinical features of cough variant asthma in a general internal medicine outpatient clinic in JapanSHIRAHATA K, FUJIMOTO K, ARIOKA H, SHOUDA R, KUDO K, IKEDA S.Respirology2005;10: 354–358The aims of the present study were to examine the prevalence and clinical features of cough variant asthma (CVA) among patients with chronic and persistent cough at an outpatient clinic in Japan, and the efficacy of treatment with an inhaled corticosteroid.This prospective study was conducted at a general internal medicine outpatient clinic in Japan over a 12-month period. CVA was diagnosed as chronic cough without wheezing or any apparent cause, that had persisted for more than 8 weeks, with a normal CXR and spirometry but with bronchial hyperresponsiveness to methacholine, and relief of cough after bronchodilator treatment. We also examined the effects of inhaled beclomethasone propionate on symptoms and differences in PEF between early morning and evening.Of 55 patients suffering from chronic cough, 23 satisfied the criteria for CVA. Their cough occurred more frequently at night and early in the morning. Early morning PEF was significantly lower than evening PEF with a mean variability of 11.5 ± 4.1%. Treatment with beclomethasone propionate improved coughing and significantly increased early morning PEF, reducing variability to less than 10%.These findings suggest that CVA is most common among patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of CVA. [ABSTRACT FROM AUTHOR]

Importance of atopic cough, cough variant asthma and sinobronchial syndrome as causes of chronic cough in Hokuriku area of JapanFUJIMURA M, ABO M, OGAWA H, NISHI K, KIBE Y, HIROSE T, NAKATSUMI Y, IWASA K.Respirology2005;10: 201–207A prospective multicentre study was conducted to elucidate the causes of chronic cough in Japan.All consecutive and unselected patients complaining of cough lasting 8 weeks or more, who visited our clinics from 1 June to 31 December 2001, were registered. The causes of chronic cough were diagnosed based on the criteria for definite and probable causes of cough as recommended by the Japanese Cough Research Society.Of the 248 patients enrolled, 72 patients (29.0%) were unavailable for follow up before their diagnostic assessment had been finalized. Among the 176 patients who were adequately assessed, a diagnosis was made in 165 patients (93.7%) either as single cause or as one of two casuses: atopic cough in 48 (29.1%) and 11 patients (6.7%); cough variant asthma in 46 (27.9%) and nine patients (5.5%); cough predominant asthma in 14 (8.5%) and three patients (1.8%); and sinobronchial syndrome (SBS) in 28 (17.7%) and 14 patients (8.5%), respectively. A diagnosis of gastro-oesophageal reflux-associated cough was made in a total of four patients (2.4%).Atopic cough, asthmatic cough consisting of cough variant asthma and cough predominant asthma, and SBS are major causes of chronic cough in Japan. [ABSTRACT FROM AUTHOR]