Impact of type 2 biomarkers on changes in subjective cough outcomes in chronic cough

<bold>Background:</bold> Asthma and Non-Asthmatic Eosinophilic Bronchitis(NAEB) are commonly treated with inhaled corticosteroids(ICS) and bronchodilators. It is unclear if the change in cough patient reported outcomes(PRO) is associated with a corresponding reduction in type 2 biomarkers(T2B). <bold>Objective:</bold> Evaluate the relationship between improvements in cough PROs and improvements in T2B in CC patients treated with ICS/LABA. <bold>Methods:</bold> A prospective observational single center cohort study. Patients were treated with ICS/LABA based on results from methacholine challenge and T2B including blood eosinophils, Fractional Exhaled Nitric Oxide(FeNO) and % sputum eosinophils. Cough PROs included measuring Leicester Cough Questionnaire(LCQ), cough severity visual analogue scale(VAS). <bold>Results:</bold> 69 patients with CC (49females;mean age,55.7±14.5yrs) were recruited. 28 patients were treated with ICS/LABA. Of these, 9 patients were responders(32%) and reported LCQ and VAS improvements above the MID(VAS change -45.0mm and LCQ change 8.2)(Fig 1). No significant relationship was observed between changes in T2B and subjective cough outcomes. Reduction in cough in responders was associated with a numerical reduction of 18.55ppb in FeNO and sputum eosinophils by 1.6%. <bold>Conclusions:</bold> Treatment with ICS/LABA resulted in improvement in cough PROs only in 32% of patients with CC. Elevated T2B seem to poorly predict treatment responses in CC patients. <fig><object-id>erj;64/suppl_68/PA324/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>