Frequent productive cough: Symptom burden and future exacerbation risk among patients with asthma and/or COPD in the NOVELTY study
Rod Hughes, Eleni Rapsomaniki, Christer Janson, Christina Keen, Barry J. Make, Pierre‐Régis Burgel, Erin Tomaszewski, Hana Müllerová, Helen K. Reddel, Gabriel Benhabib, Xavier Bocca Ruiz, Ricardo del Olmo, Raúl Lisanti, Gustavo Marino, Walter Mattarucco, Juan Nogueira, Maria Parody, Pablo Pascale, Pablo Rodriguez, Damian Silva, Graciela Svetliza, Carlos Victorio, Roxana Willigs Rolon, Anahí Yáñez, Stuart Baines, Simon Bowler, Peter Bremner, Sheetal Bull, Patrick Carroll, Mariam Chaalan, Claude S. Farah, Gary Hammerschlag, Kerry Hancock, Zinta Harrington, Gregory Katsoulotos, Joshua Kim, David Langton, Donald Lee, Matthew Peters, Lakshman Prassad, Helen K. Reddel, Dimitar Sajkov, Francis Santiago, Frederick Graham Simpson, Sze Tai, Paul S. Thomas, Peter Wark, José Eduardo Delfini Cançado, Thúlio Cunha, Marina Andrade Lima, Alexandre Pinto Cardoso, Marcelo Fouad Rabahi, Syed Anees, John Bertley, Alan Bell, Amarjit Cheema, Guy Chouinard, Michael Csanadi, Anil Dhar, Ripple Dhillon, J Mark FitzGerald, David Kanawaty, Allan Kelly, William Killorn, Daniel Landry, Robert Luton, Piush J. Mandhane, Andrew McIvor, Bonavuth Pek, Robert Petrella, Daniel Stollery, Meihua Chen, Yan Chen, Wei Gu, Kim Ming Christopher Hui, Manxiang Li, Shiyue Li, Li-Jun Ma, Guangyue Qin, Weidong Song, Wei Tan, Yijun Tang, Chen Wang, Tan Wang, Fuqiang Wen, Feng Wu, PingChao Xiang, Zuke Xiao, Shengdao Xiong, Jinghua Yang, Jingping Yang, Wei Zhang, Min Zhang, Ping Zhang, Wei Zhang, Xiaohe Zheng, Dan Zhu, Fabio Bolívar Grimaldos, Alejandra Cañas Arboleda, Carlos Matiz Bueno
Abstract
Introduction: Persistent cough with sputum production is an important clinical trait in chronic obstructive pulmonary disease (COPD). We defined "frequent productive cough" based on 2 questions from the St George's Respiratory Questionnaire (SGRQ) and sought to determine its occurrence and associated outcomes in patients with physician-assigned asthma and/or COPD from the NOVELTY study. Methods: Frequent productive cough was defined as cough and sputum production most or several days/week for the past 3 months (scoring 3 for both SGRQ questions). Relationships with baseline disease characteristics and exacerbations over 12 months' follow-up were examined using logistic regression. Results: Baseline SGRQ data were available for 7125 patients, of whom 31.3% had frequent productive cough. It was more common in asthma + COPD (38.8%) and COPD (38.1%) than asthma (25.0%), increasing with physician-assessed severity, and in current versus former and never smokers. Patient-reported symptomatic worsening was more common in patients with versus without frequent productive cough. Reduced postbronchodilator FEV 1 (odds ratio [OR] per 10% decrement 1.14 [95% confidence interval 1.11-1.16]) and history of pollutant exposure at home/work ) were associated with frequent productive cough in all diagnoses. Patients with baseline frequent productive cough were more likely to have 1 exacerbation over the subsequent 12 months ), including exacerbations requiring hospital admission and those treated with oral corticosteroids. Conclusions: Frequent productive cough represents an important indicator of adverse clinical outcomes across asthma and/or COPD. Research into the underlying pathologic mechanisms is required to support targeted therapy development. Clinicaltrials.