Chronic cough and gastro-oesophageal reflux: a double-blind placebo-controlled study with omeprazole

Kiljander, Toni; Salomaa, Eija-Riitta; Hietanen, Eino; Terho, E. O.

doi:10.1034/j.1399-3003.2000.16d11.x

Cited by 137 publications

(117 citation statements)

References 24 publications

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“…In a recent 5-year follow-up of the original ProGERD study, the prevalence of asthma in GERD patients had increased from 4.5% at entry to 7.8% at the end of follow-up. 82 Kiljander et al 83 showed that 35% of asthma patients had abnormal 24-hour esophageal pH monitoring.…”

Section: -74mentioning

confidence: 99%

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

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Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the therapeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, maintenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett's esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any future development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the aforementioned areas of unmet need.

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Section: -74mentioning

confidence: 99%

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

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“…16,[34][35][36][37][38] Shaheen et al 37 ( Table 1 ) reported data separately for patients with and without pathologic esophageal acid exposure and, thus, contributed two datasets, resulting in a total of seven datasets for further analysis. One dataset showed no therapeutic gain ( Table 1 ).…”

Section: Therapeutic Response Of Chronic Cough To Acid-suppressive Thmentioning

confidence: 99%

“…Five used patient diaries consisting of visual analog scales to assess cough severity and/or frequency ( Table 1), 13,16,34,36,38 questionnaires were used in two studies ( Table 1 ), 14,35 and two studies did not specify the method of data acquisition ( Table 1 ). 15,37 Two studies assessed efficacy in terms of the proportion of patients who met prespecifi ed criteria for response ( Table 1 ) 16,36 ; the remainder measured change in mean cough scores relative to baseline for treatment vs placebo.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…[13][14][15][16][34][35][36][37][38] All assessed pharmacologic interventions for cough (no placebo-controlled studies assessing surgery were found); eight assessed PPIs (once daily or bid for 8-16 weeks) [13][14][15][16][34][35][36][37] ; and one assessed the histamine type 2-receptor antagonist ranitidine, 150 mg daily for 8 weeks. 38 No unpublished data were used in this review because no additional information that aided the analysis was obtained from authors.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Response of Chronic Cough to Acid-Suppressive Therapy in Patients With Gastroesophageal Reflux Disease

Kahrilas

Howden

Hughes

et al. 2013

Chest

157

100

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Background: Epidemiologic and physiologic studies suggest an association between gastroesophageal refl ux disease (GERD) and chronic cough. However, the benefi t of antirefl ux therapy for chronic cough remains unclear, with most relevant trials reporting negative fi ndings. This systematic review aimed to reevaluate the response of chronic cough to antirefl ux therapy in trials that allowed us to distinguish patients with or without objective evidence of GERD. Methods: PubMed and Embase systematic searches identifi ed clinical trials reporting cough response to antirefl ux therapy. Datasets were derived from trials that used pH-metry to characterize patients with chronic cough. Results: Nine randomized controlled trials of varied design that treated patients with acid suppression were identifi ed (eight used proton pump inhibitors [PPIs], one used ranitidine). Datasets from two crossover studies showed that PPIs signifi cantly improved cough relative to placebo, albeit only in the arm receiving placebo fi rst. Therapeutic gain in seven datasets was greater in patients with pathologic esophageal acid exposure (range, 12.5%-35.8%) than in those without (range, 0.0%-8.6%), with no overlap between groups. Conclusions: A therapeutic benefi t for acid-suppressive therapy in patients with chronic cough cannot be dismissed. However, evidence suggests that rigorous patient selection is necessary to identify patient populations likely to be responsive, using physiologically timed cough events during refl ux testing, minimal patient exclusion because of presumptive alternative diagnoses, and appropriate power to detect a modest therapeutic gain. Only then can we hope to resolve this vexing clinical management problem. CHEST 2013; 143(3):605-612Abbreviations: GERD 5 gastroesophageal refl ux disease; LPR 5 laryngopharyngeal refl ux; PPI 5 proton pump inhibitor

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“…[32] On the contrary, other studies have shown a less good response rate. [33;34] In many of these studies, patients were asked to fill in a questionnaire about their symptoms, without using objective measurement for cough.…”

Section: Treatment Of Reflux Related Coughmentioning

confidence: 99%

Cough and gastroesophageal reflux: From the gastroenterologist end

Pauwels¹,

Blondeau²,

Dupont³

et al. 2009

Pulmonary Pharmacology & Therapeutics

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Gastroesophageal reflux (GER) is one of the three most common causes of chronic unexplained cough. Diagnosing GER related cough is challenging since many patients do not have esophagitis or an increased esophageal acid exposure during 24h esophageal pH-metry. A significant time association between acid reflux and cough can be demonstrated in a subgroup of patients, even if the total esophageal acid exposure is normal. Establishing an exact time relationship between reflux and cough requires objective measurements of both cough and reflux episodes. A variety of techniques for cough assessment are available, including sound recordings and continuous measurement of gastroesophageal pressures. The Symptom Association Probability (SAP) has been suggested as the most reliable algorithm to establish the non-chance association between GER and cough. Although the relationship between acid reflux and cough is generally accepted, the response rate of patients with chronic unexplained cough to proton pump inhibitor treatment (PPI) is poorer compared to that in patients with typical GERD symptoms. Combined impedance-pH recordings, a new technique for the measurement of all types of reflux, have recently shown that not only acid but also weakly acidic GER may be associated with cough. Moreover, measurements in patients "on" PPI therapy demonstrated that weakly acidic reflux may persist during PPI treatment and may be associated with cough.

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Chronic cough and gastro-oesophageal reflux: a double-blind placebo-controlled study with omeprazole

Cited by 137 publications

References 24 publications

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Response of Chronic Cough to Acid-Suppressive Therapy in Patients With Gastroesophageal Reflux Disease

Cough and gastroesophageal reflux: From the gastroenterologist end

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