AIM:
We conducted this systematic review and meta-analysis to investigate the efficacy and safety of gefapixant, a novel P2X3 receptor antagonist, in patients with chronic cough.
METHODS:
We searched four databases for randomized controlled trials (RCTs). We assessed the cough frequency, severity, total Leicester cough questionnaire (LCQ) score, and adverse events. We analyzed the data using Open Meta-Analyst and Review Manager Software.
RESULTS:
We included four unique studies (comprising five stand-alone RCTs) with 439 patients. Compared to placebo, gefapixant had positive anti-tussive effects by improving awake cough frequency (mean difference [MD] = −5.27, 95% confidence interval [CI] [−6.12, −4.42],
P
< 0.00001), night cough frequency (MD = −3.71, 95% CI [−6.57, −0.85],
P
= 0. 01), 24 h cough frequency (MD = −4.18, 95% CI [−5.01, −3.36],
P
< 0.00001), cough severity using the Visual Analog Scale (MD = −13.36, 95% CI [−17.80, −8.92],
P
< 0.00001), cough severity diary (MD = −0.88, 95% CI [−1.25, −0.51],
P
< 0.00001), and total LCQ score (MD = 2.00, 95% CI [1.15, 2.86],
P
= 0. 00001). Meta-regression analyses showed a positive correlation between the gefapixant dose and the incidence of any adverse event (relative risk [RR] = 0.239, 95% CI [0.093, 1.839],
P
= 0.001) and incidence of adverse event related to treatment (RR = 0.520, 95% CI [0.117, 0.922],
P
= 0.011).
CONCLUSIONS:
In patient with chronic cough, gefapixant exhibits favorable anti-tussive outcomes by improving the cough frequency, severity, and quality of life. While gefapixant is largely tolerable, its side effects (notably taste alteration) are dose dependent.
