Association of chronic nasal symptoms with dyspnoea and quality‐of‐life impairment in chronic obstructive pulmonary disease

Caillaud, D.; Chanez, Pascal; Escamilla, R.; Burgel, Pierre‐Régis; Court-Fortuné, Isabelle; Nesme-Meyer, Pascale; Deslée, G.; Pérez, Thierry; Pinet, C.; Roche, N.; Investigators,

doi:10.1111/resp.12224

Cited by 15 publications

(20 citation statements)

References 41 publications

(51 reference statements)

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“…187 Caillaud et al noted a prevalence of 42% of chronic nasal symptoms in a group of 274 patients with COPD which were associated with both the presence of hay fever and atopic dermatitis diagnoses. 188 These individuals were found to have worse quality of life and more dyspnea than COPD participants without nasal symptoms. Ultimately, better understanding the subgroup of patients with COPD and allergic disease could lead to efforts to develop specialized therapeutic strategies for this subgroup of COPD.…”

Section: Chronic Obstructive Pulmonary Disease and Allergic Diseasementioning

confidence: 97%

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

Putcha

Drummond

Wise

et al. 2015

Semin Respir Crit Care Med

146

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Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies.

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Section: Chronic Obstructive Pulmonary Disease and Allergic Diseasementioning

confidence: 97%

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

Putcha

Drummond

Wise

et al. 2015

Semin Respir Crit Care Med

146

View full text Add to dashboard Cite

show abstract

“…In our patients with upper airways symptoms, SPT was positive in 11 of 27 (40.7%) as compared to 1 of 14 patients ( p = 0.02) in those without indicating an element of an atopic background. Based only on clinical evaluation, a study from France [ 7 ] too reported similar observation. The authors had suggested that “atopy is indeed involved in chronic nasal symptoms among COPD patients” and they further stated that “atopy was defined on a purely clinical basis with no confirmation by skin prick tests or radioallergosorbent test (specific immunoglobulin E dosage)” [ 7 ].…”

Section: Discussionmentioning

confidence: 62%

“…A postal questionnaire survey in 392 patients with self-reported chronic bronchitis or emphysema documented recurrent or permanent nasal complaints in 40% subjects [ 4 ]. In more specific studies, the frequency of upper airways symptoms ranged from 42%–88% [ 5 6 7 ]. In the East London COPD rolling cohort study, 88% of the 65 patients had one or the other upper airways symptoms [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Frequency and effect of type 1 hypersensitivity in patients from India with chronic obstructive pulmonary disease and associated upper airways symptoms

Kumar

Kunal

Shah

2017

Asia Pacific Allergy

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BackgroundChronic obstructive pulmonary disease (COPD) is now recognized as a systemic disorder with many comorbidities. Atopy in patients with COPD and upper airways symptoms has not been characterized.ObjectiveWe investigated the occurrence and impact of aeroallergen sensitisation in patients with COPD and upper airways symptoms.MethodsAll 41 subjects with COPD diagnosed as per Global Initiative for Chronic Obstructive Lung Disease guidelines, underwent spirometry with reversibility, computed tomography of the paranasal sinuses (CT-PNS), skin prick test (SPT) against common aeroallergens and responded to St. George's Respiratory Questionnaire (SGRQ) and Sino Nasal Outcome Test - 22 (SNOT-22) questionnaires. Upper airways symptoms were assessed as per the Allergic Rhinitis and its Impact on Asthma guidelines.ResultsAs documented earlier, 27 of the 41 patients (65.9%) with COPD had upper airways symptoms. Of these 27 patients, 11 had SPT positivity against at least one aeroallergen (group 1). One patient had monosensitisation to pollens of grass Imperata while polysensitisation was seen in 10/11 patients commonly to weeds, trees, and insects. Fungal sensitisation to Aspergillus fumigatus was seen in 3 of 11 patients (27.2%). In group 1, all 11 patients (100%) had radiological sinusitis as compared to 8 of 16 (50%) in group 2. The mean CT-PNS scores were significantly higher in group 1 as compared to group 2. Similarly, the SNOT-22 scores were significantly higher in group 1 as compared to group 2. However, there was no difference in SGRQ scores between the 2 groups. In group 1, there was a significant correlation between CT-PNS and SNOT-22 scores.ConclusionPatients with COPD, associated upper airways symptoms and a positive SPT had a significantly higher frequency of radiological sinusitis on CT-PNS. They even had worse quality of life as compared to those with a negative SPT. The study suggested that atopic patients with COPD and upper airways involvement were more symptomatic. It is therefore possible that upper airways symptoms, if left untreated, would result in less than desirable control of the disease.

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“…For example, in a retrospective analysis of 39 patients with difficult asthma complaining of exertional dyspnoea, 14 patients had a hyperventilation disorder, two had deconditioning, one had cardiac ischaemia and nine individuals had two simultaneous explanatory features diagnosed by CPET [64]. Nasal obstruction and other chronic nasal symptoms, which are common in asthma, have been reported to be associated with dyspnoea in COPD [65]. However, whether nasal disease contributes to dyspnoea in asthma has not been investigated.…”

Section: Respiratory Muscle Functionmentioning

confidence: 99%

Mechanisms, measurement and management of exertional dyspnoea in asthma

et al. 2017

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Asthma is a heterogeneous condition, with dyspnoea during exercise affecting individuals to a variable degree. This narrative review explores the mechanisms and measurement of exertional dyspnoea in asthma and summarises the available evidence for the efficacy of various interventions on exertional dyspnoea. Studies on the mechanisms of dyspnoea in asthma have largely utilised direct bronchoprovocation challenges, rather than exercise, which may invoke different physiological mechanisms. Thus, the description of dyspnoea during methacholine challenge can differ from what is experienced during daily activities, including exercise. Dyspnoea perception during exercise is influenced by many interacting variables, such as asthma severity and phenotype, bronchoconstriction, dynamic hyperinflation, respiratory drive and psychological factors. In addition to the intensity of dyspnoea, the qualitative description of dyspnoea may give important clues as to the underlying mechanism and may be an important endpoint for future interventional studies. There is currently little evidence demonstrating whether pharmacological or non-pharmacological interventions specifically improve exertional dyspnoea, which is an important area for future research.

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Association of chronic nasal symptoms with dyspnoea and quality‐of‐life impairment in chronic obstructive pulmonary disease

Abstract: In this group of COPD subjects, CNS were frequently observed and associated with dyspnoea and poorer QoL. CNS should be systematically assessed and could be a potential target in the management of COPD.

Cited by 15 publications

References 41 publications

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

Frequency and effect of type 1 hypersensitivity in patients from India with chronic obstructive pulmonary disease and associated upper airways symptoms

Mechanisms, measurement and management of exertional dyspnoea in asthma

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