Treatment of Interstitial Lung Disease Associated Cough

CHEST Guideline and Expert Panel Report

Collaborators

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD. Methods: This systematic review asked: Is there evidence of clinically relevant treatment effects for therapies for cough in ILD? Studies of adults aged > 18 years with a chronic cough ≥ 8 weeks’ duration were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using CHEST guideline methodology. Results: Eight randomized controlled trials and two case series (≥ 10 patients) were included that reported data on patients with idiopathic pulmonary fibrosis, sarcoidosis, and scleroderma-related ILD who received a variety of interventions. Study quality was high in all eight randomized controlled trials. Inhaled corticosteroids were not supported for cough associated with sarcoidosis. Cyclophosphamide and mycophenolate were not supported for solely treating cough associated with scleroderma-associated ILD. A recommendation for thalidomide to treat cough associated with idiopathic pulmonary fibrosis did not pass the panel vote. In view of the paucity of antitussive treatment options for refractory cough in ILD, the guideline panel suggested that the CHEST unexplained chronic cough guideline be followed by considering options such as the neuromodulator gabapentin and speech pathology management. Opiates were also suggested for patients with cough refractory to alternative therapies. Conclusions: The evidence supporting the management of chronic cough in ILD is limited. This guideline presents suggestions for managing and treating cough on the best available evidence, but future research is clearly needed.

Original languageEnglish (US)
Pages (from-to)904-917
Number of pages14
JournalChest
Volume154
Issue number4
DOIs
StatePublished - Oct 1 2018

Fingerprint

Interstitial Lung Diseases
Cough
Guidelines
Therapeutics
Idiopathic Pulmonary Fibrosis
Opiate Alkaloids
Randomized Controlled Trials
Speech-Language Pathology
Antitussive Agents
Pulmonary Sarcoidosis
Thalidomide
Sarcoidosis
Complementary Therapies
Cyclophosphamide
Neurotransmitter Agents
Adrenal Cortex Hormones
Quality of Life

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Treatment of Interstitial Lung Disease Associated Cough : CHEST Guideline and Expert Panel Report. / Collaborators.

In: Chest, Vol. 154, No. 4, 01.10.2018, p. 904-917.

Research output: Contribution to journalArticle

@article{66bd0d052d4a4428a3a53a738844de73,
title = "Treatment of Interstitial Lung Disease Associated Cough: CHEST Guideline and Expert Panel Report",
abstract = "Background: Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD. Methods: This systematic review asked: Is there evidence of clinically relevant treatment effects for therapies for cough in ILD? Studies of adults aged > 18 years with a chronic cough ≥ 8 weeks’ duration were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using CHEST guideline methodology. Results: Eight randomized controlled trials and two case series (≥ 10 patients) were included that reported data on patients with idiopathic pulmonary fibrosis, sarcoidosis, and scleroderma-related ILD who received a variety of interventions. Study quality was high in all eight randomized controlled trials. Inhaled corticosteroids were not supported for cough associated with sarcoidosis. Cyclophosphamide and mycophenolate were not supported for solely treating cough associated with scleroderma-associated ILD. A recommendation for thalidomide to treat cough associated with idiopathic pulmonary fibrosis did not pass the panel vote. In view of the paucity of antitussive treatment options for refractory cough in ILD, the guideline panel suggested that the CHEST unexplained chronic cough guideline be followed by considering options such as the neuromodulator gabapentin and speech pathology management. Opiates were also suggested for patients with cough refractory to alternative therapies. Conclusions: The evidence supporting the management of chronic cough in ILD is limited. This guideline presents suggestions for managing and treating cough on the best available evidence, but future research is clearly needed.",
author = "Collaborators and Birring, {Surinder S.} and Kavanagh, {Joanne E.} and Irwin, {Richard S.} and Keogh, {Karina A.} and Lim, {Kaiser G.} and Ryu, {Jay H.} and Adams, {Todd M.} and Altman, {Kenneth W.} and Elie Azoulay and Barker, {Alan F.} and Birring, {Surinder S.} and Fiona Blackhall and Boulet, {Louis Philippe} and Braman, {Sidney S.} and Christopher Brightling and Priscilla Callahan-Lyon and Chang, {Anne B.} and Paul Davenport and {El Solh}, {Ali A.} and Patricio Escalante and Field, {Stephen K.} and Dina Fisher and French, {Cynthia T.} and Cameron Grant and Harding, {Susan M.} and Philip Gold and Anthony Harnden and Hill, {Adam T.} and Irwin, {Richard S.} and Kahrilas, {Peter J.} and Joanne Kavanagh and Keogh, {Karina A.} and Kefang Lai and Lane, {Andrew P.} and Kaiser Lim and Madison, {J. Mark} and Malesker, {Mark A.} and Stuart Mazzone and Lorcan McGarvey and Alex Molasoitis and Abigail Moore and Murad, {M. Hassan} and Mangala Narasimhan and Nguyen, {Huong Q.} and Peter Newcombe and John Oppenheimer and Restrepo, {Marcos I.} and Mark Rosen and Bruce Rubin and Ryu, {Jay H.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.chest.2018.06.038",
language = "English (US)",
volume = "154",
pages = "904--917",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "4",

}

TY - JOUR

T1 - Treatment of Interstitial Lung Disease Associated Cough

T2 - CHEST Guideline and Expert Panel Report

AU - Collaborators

AU - Birring, Surinder S.

AU - Kavanagh, Joanne E.

AU - Irwin, Richard S.

AU - Keogh, Karina A.

AU - Lim, Kaiser G.

AU - Ryu, Jay H.

AU - Adams, Todd M.

AU - Altman, Kenneth W.

AU - Azoulay, Elie

AU - Barker, Alan F.

AU - Birring, Surinder S.

AU - Blackhall, Fiona

AU - Boulet, Louis Philippe

AU - Braman, Sidney S.

AU - Brightling, Christopher

AU - Callahan-Lyon, Priscilla

AU - Chang, Anne B.

AU - Davenport, Paul

AU - El Solh, Ali A.

AU - Escalante, Patricio

AU - Field, Stephen K.

AU - Fisher, Dina

AU - French, Cynthia T.

AU - Grant, Cameron

AU - Harding, Susan M.

AU - Gold, Philip

AU - Harnden, Anthony

AU - Hill, Adam T.

AU - Irwin, Richard S.

AU - Kahrilas, Peter J.

AU - Kavanagh, Joanne

AU - Keogh, Karina A.

AU - Lai, Kefang

AU - Lane, Andrew P.

AU - Lim, Kaiser

AU - Madison, J. Mark

AU - Malesker, Mark A.

AU - Mazzone, Stuart

AU - McGarvey, Lorcan

AU - Molasoitis, Alex

AU - Moore, Abigail

AU - Murad, M. Hassan

AU - Narasimhan, Mangala

AU - Nguyen, Huong Q.

AU - Newcombe, Peter

AU - Oppenheimer, John

AU - Restrepo, Marcos I.

AU - Rosen, Mark

AU - Rubin, Bruce

AU - Ryu, Jay H.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD. Methods: This systematic review asked: Is there evidence of clinically relevant treatment effects for therapies for cough in ILD? Studies of adults aged > 18 years with a chronic cough ≥ 8 weeks’ duration were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using CHEST guideline methodology. Results: Eight randomized controlled trials and two case series (≥ 10 patients) were included that reported data on patients with idiopathic pulmonary fibrosis, sarcoidosis, and scleroderma-related ILD who received a variety of interventions. Study quality was high in all eight randomized controlled trials. Inhaled corticosteroids were not supported for cough associated with sarcoidosis. Cyclophosphamide and mycophenolate were not supported for solely treating cough associated with scleroderma-associated ILD. A recommendation for thalidomide to treat cough associated with idiopathic pulmonary fibrosis did not pass the panel vote. In view of the paucity of antitussive treatment options for refractory cough in ILD, the guideline panel suggested that the CHEST unexplained chronic cough guideline be followed by considering options such as the neuromodulator gabapentin and speech pathology management. Opiates were also suggested for patients with cough refractory to alternative therapies. Conclusions: The evidence supporting the management of chronic cough in ILD is limited. This guideline presents suggestions for managing and treating cough on the best available evidence, but future research is clearly needed.

AB - Background: Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD. Methods: This systematic review asked: Is there evidence of clinically relevant treatment effects for therapies for cough in ILD? Studies of adults aged > 18 years with a chronic cough ≥ 8 weeks’ duration were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using CHEST guideline methodology. Results: Eight randomized controlled trials and two case series (≥ 10 patients) were included that reported data on patients with idiopathic pulmonary fibrosis, sarcoidosis, and scleroderma-related ILD who received a variety of interventions. Study quality was high in all eight randomized controlled trials. Inhaled corticosteroids were not supported for cough associated with sarcoidosis. Cyclophosphamide and mycophenolate were not supported for solely treating cough associated with scleroderma-associated ILD. A recommendation for thalidomide to treat cough associated with idiopathic pulmonary fibrosis did not pass the panel vote. In view of the paucity of antitussive treatment options for refractory cough in ILD, the guideline panel suggested that the CHEST unexplained chronic cough guideline be followed by considering options such as the neuromodulator gabapentin and speech pathology management. Opiates were also suggested for patients with cough refractory to alternative therapies. Conclusions: The evidence supporting the management of chronic cough in ILD is limited. This guideline presents suggestions for managing and treating cough on the best available evidence, but future research is clearly needed.

UR - http://www.scopus.com/inward/record.url?scp=85053799313&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053799313&partnerID=8YFLogxK

U2 - 10.1016/j.chest.2018.06.038

DO - 10.1016/j.chest.2018.06.038

M3 - Article

VL - 154

SP - 904

EP - 917

JO - Chest

JF - Chest

SN - 0012-3692

IS - 4

ER -