Lower Airway Allergy Treatments
Cough is the primary symptom outcome of interest in lower airway
allergy, alongside airway limitation symptoms. Inhaled corticosteroids
and bronchodilators (particularly beta-2 agonists) are the mainstay of
treatment, but a range of alternative and adjucnt treatments options
exist, inclusive of systemic corticosteroids, antihistamines, inhaled
bronchodilators, inhaled or systemtic anti-muscarinic agents and
immunotherapy. We struggled to identify meaningful data which reports
treatment impacts on persistent irritative UCTS in this setting, beyond
those studies which note deleterious effects on inhaled corticosteroids
on voice parameters. One study [45 ] found patients undergoing
immunotherapy for asthma and other airway allergy phenotypes reported
reduced vocal symptoms in proportion to treatment duration, including
lower reliance on inhaled corticosteroids. This may be of significance
in patients reliant on inhaled corticosteroids in whom chronic dysphonia
is a complaint, but further research is necessary to guide
recommendation. Outside of cough, treatment considerations or adjuncts
which account for for chronic throat complaints in the patient with
bronchopulmonary allergy remain undefined.