Background Although cough is a common and troublesome symptom in asthma, clinicians do not routinely assess its impact or severity. A more comprehensive approach to cough may be of particular relevance in severe asthma where poor symptom control often leads to escalation in corticosteroid therapy.

Objectives In this study, we aim to assess the role of cough in patients with severe refractory asthma using cough-related patient reported outcome measurement tools. Here we present preliminary data from our first nineteen patients.

Methods Nineteen severe asthmatic patients were assessed using five cough measurement tools consisting of the Leicester Cough Questionnaire (LCQ), Cough-Specific Quality-of-life Questionnaire (CQLQ), and Visual Analogue Scales for cough severity (VASc) and urge to cough (VASu). In addition, a cough challenge was performed, with cough responses assessed for the concentration of citric acid needed to evoke two (C₂) or five (C₅) coughs. Results were compared with scores from the Asthma Control Questionnaire – 5 (ACQ-5) and Mini Asthma Quality of Life Questionnaire (Mini AQLQ).

Results Our preliminary analysis shows that scores from the LCQ and CQLQ have a strong inverse relationship in this population (r_s=−0.69, p≤0.01). Scores from the LCQ demonstrated a very strong association with both the ACQ-5 (r_s=−0.88, p≤0.01) and Mini AQLQ (r_s=0.83, p<0.01). In a similar fashion, CQLQ scores show a moderate association with the ACQ-5 (r_s=−0.58, p≤0.01) and a strong association with the Mini AQLQ (r_s=−0.67, p<0.01). VASc scores were moderately correlated with ACQ-5 (r_s=0.47, p=0.04) and Mini AQLQ (r_s=−0.49, p=0.04). Additionally, VASu scores also show a stronger relationship with ACQ-5 (r_s=0.54, p=0.02) and Mini AQLQ (r_s=−0.62, p<0.01). Finally, no significant associations were observed between C₂ or C₅ endpoints and any other study measurements.

Conclusion Despite not being extensively considered in the assessment of severe asthma, cough may be a driving component of asthma control and asthma-related quality-of-life.