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.