Lombardi Carlo, Berti Alvise, Menzella Francesco, Cottini Marcello
Departmental Unit of Allergology & Pneumology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Center for Medical Sciences (CISMed) and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy.
Drugs Context. 2025 Aug 26;14. doi: 10.7573/dic.2025-6-3. eCollection 2025.
Cough is a major symptom of asthma and is associated with poor clinical outcomes. However, current guidelines place little emphasis on the crucial relevance of the cough symptom and its treatment. The objective of this study was to assess the impact of dupilumab on chronic cough (CC) in patients with severe eosinophilic asthma (SEA) and chronic rhinosinusitis with nasal polyps (CRSwNP).
Patients with CC and SEA, CRSwNP, or SEA plus CRSwNP treated with dupilumab were prospectively included. Patients were evaluated before and after 6 months of treatment by collecting Severe Cough Visual Analogue Scale (SC-VAS) scores and the Leicester Cough Questionnaire (LCQ). A total of 67 patients with CC were included.
Both SC-VAS and LCQ significantly improved after 6 months in the whole group (paired -test SC-VAS, mean (SD), from 83.13 (11.54) to 38.21; and LCQ, from 1.98 (0.78) to 4.54 (1.35), both <0.001), and in each disease subset (paired -test, <0.001 in all groups). After treatment, 73% and 82% of patients had a clinically meaningful improvement of SC-VAS and LCQ, respectively.
Dupilumab was found to be associated with significant improvement in CC in 50% (=10) of patients with SEA, in 73% (=19) of patients with CRSwNP, and in 62% (=13) of patients with SEA plus CRSwNP, respectively. In this real-life study, dupilumab significantly reduced CC whilst improving quality of life in patients with SEA with or without CRSwNP. These results support the potential role of dupilumab in the treatment of cough as a treatable trait.
咳嗽是哮喘的主要症状，且与不良临床结局相关。然而，当前指南很少强调咳嗽症状及其治疗的关键相关性。本研究的目的是评估度普利尤单抗对重度嗜酸性粒细胞性哮喘（SEA）和伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者慢性咳嗽（CC）的影响。
前瞻性纳入接受度普利尤单抗治疗的CC合并SEA、CRSwNP或SEA加CRSwNP患者。在治疗6个月前后，通过收集严重咳嗽视觉模拟量表（SC-VAS）评分和莱斯特咳嗽问卷（LCQ）对患者进行评估。共纳入67例CC患者。
整个组在6个月后SC-VAS和LCQ均显著改善（配对t检验，SC-VAS，均值（标准差），从83.13（11.54）降至38.21；LCQ从1.98（0.78）升至4.54（1.35），均P<0.001），且在每个疾病亚组中也是如此（配对t检验，所有组均P<0.001）。治疗后，分别有73%和82%的患者SC-VAS和LCQ有临床意义的改善。
发现度普利尤单抗分别使50%（=10）的SEA患者、73%（=19）的CRSwNP患者和62%（=13）的SEA加CRSwNP患者的CC有显著改善。在这项真实世界研究中，度普利尤单抗显著减轻了CC，同时改善了有或无CRSwNP的SEA患者的生活质量。这些结果支持度普利尤单抗在将咳嗽作为可治疗特征进行治疗方面的潜在作用。
