Professor Liam Heaney and Dr Lorcan McGarvey
Name of the Study:
A cross-sectional study to measure cough in severe asthma
Why is this Study important?:
Despite cough being important in normal human respiratory health, it can become disordered in conditions such as asthma. Cough is often described as one of the most problematic symptoms associated with asthma and when it becomes uncontrolled it tends to drive treatment escalation with corticosteroids and often in situations when these are unlikely to provide benefit.
Asthma is typically associated with eosinophilic airways inflammation driven by Type-2 cytokines in the airways (interleukins 4, 5 and 13). A novel approach to adjusting corticosteroid treatment is being explored in the UK Refractory Asthma Stratification programme (RASP-UK - www.rasp.org.uk ) using individual inflammatory biomarker profiles. Only half of patients on inhaled steroid treatment with asthma have typical inflammation driven by Type-2 cytokines and are termed “T2-high” patients. The remaining patients have less evidence of this type of inflammation playing a role in their condition and are classed as “T2-Low” but have persisting symptoms. We hypothesise that cough represents a significant burden in severe asthma which can be defined using subjective and objective cough measures which will allow us to make comparisons between the different inflammatory groups.
What is the Research question/aim?:
This study aims to characterise cough in severe asthma through an observational cross-sectional analysis of patients stratified by inflammatory biomarker profile.
To measure cough frequency, cough reflex sensitivity, cough severity and asthma related quality of life in asthmatic patients and make comparisons between these results and established markers of asthma severity.
What the Study involves:
Two types of severe asthmatics (“T2-High” and “T2-Low”) and mild/moderate disease group will be recruited. 60 patients (20 from each group) will attend a baseline visit where cough and asthma related measurements will be taken as well as blood, urine and sputum samples. Patients will be given a cough monitor to wear for 24 hours.
Patients will be asked to return for a follow-up visit 2 weeks later to assess reproducibility of cough measurements. At this visit, only asthma and cough-related measurements will be taken.
A cough monitor will be used to measure cough frequency and questionnaires will be used to assess the impact of cough.
Patients will be recruited from general respiratory clinics within the Belfast Health and Social Care Trust.
Who can take part in the Study?:
Two types of severe asthmatics (“T2-High” and “T2-Low”) and mild/moderate disease group will be recruited.
Professor Liam Heaney
Phone: 028 9097 6479
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