Frequent Productive Cough Common in Patients With Chronic Obstructive Lung Disease, Asthma

Frequent productive cough (FPC) was associated with an increased risk for adverse clinical outcomes among patients with chronic obstructive pulmonary disease (COPD) and/or asthma, according to study findings published in Respiratory Medicine.

To investigate the occurrence and associated outcomes of frequent productive cough (FPC), researchers conducted a retrospective analysis using data captured from 7125 patients enrolled in the NOVELTY study (ClinicalTrials.gov Identifier: NCT02760329). Of patients included in the analysis, 3754 had asthma, 2484 had COPD, and 887 had both diseases. The presence of FPC was assessed at baseline via the St George Respiratory Questionnaire. Multivariable logistic regression was used to assess associations between FPC and patients’ baseline demographic and disease characteristics, with age, sex, and current smoking status selected as covariates.

The prevalence of FPC was increased in patients who were current smokers (48.5%) compared with those who were former smokers (30.6%) and those who never smoked (24.6%). Of patients who never smoked, the prevalence of FPC was increased among those with COPD vs those with asthma (40.9% vs 23.0%). The researchers found that FPC was most common among patients with asthma plus COPD (38.5%), followed by those with COPD alone (38.1%) and those with asthma alone (25.0%). For all patients, self-reported worsening of symptoms 3 months before baseline occurred more frequently in those with vs without FPC.

Among all patients, exposure to pollutants (odds ratio [OR], 1.50; 95% CI, 1.33-1.69) and decreased forced expiratory volume in the first second (FEV₁) following bronchodilator treatment (OR, 1.14 per 10% decrement; 95% CI, 1.11-1.16) were independently associated with FPC. Between baseline and month 12, the risk for at least 1 disease exacerbation (OR, 1.71; 95% CI, 1.52-1.93) or an exacerbation requiring subsequent hospitalization (OR, 1.93; 95% CI, 1.50-2.48) was increased among patients with FPC at baseline.

This study was limited by the lack of imaging data and the inability to analyze patients’ sputum.

“Although asthma and COPD are sometimes simplistically characterized by wheeze and cough, respectively, this analysis confirms that both cough and sputum productions are frequent chronic symptoms in patients with asthma and/or COPD,” the researchers concluded.

Disclosure: The NOVELTY study is funded by AstraZeneca. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Hughes R, Rapsomaniki E, Janson C, et al. Frequent productive cough: symptom burden and future exacerbation risk among patients with asthma and/or COPD in the NOVELTY study. Respir Med. Published online June 19, 2022. doi:10.1016/j.rmed.2022.106921