Levodropropizine for treating cough in adult and children: a meta-analysis of published studies

Zanasi, Alessandro; Lanata, Luigi; Fontana, Giovanni; Saibene, Federico; Dicpinigaitis, Peter V.; Blasio, Francesco De

doi:10.1186/s40248-015-0014-3

Cited by 37 publications

(16 citation statements)

References 13 publications

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“…Our present results with codeine confirm our earlier work in this model ( Adcock et al, 2003 ) and provide a useful positive control against which to assess other agents. We also saw a significant effect of another clinically effective antitussive, levodropropizine ( Dicpinigaitis et al, 2014 ; Zanasi et al, 2015 ), but were not able to see any significant antitussive effect of the H1 receptor antagonist chlorpheniramine, despite the fact that this class of drug has been claimed to have modest antitussive effects clinically, albeit not in all studies ( Dicpinigaitis et al, 2014 ).…”

Section: Discussionmentioning

confidence: 83%

Ozone-Induced Hypertussive Responses in Rabbits and Guinea Pigs

Clay¹,

Patacchini²,

Trevisani³

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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Cough remains a major unmet clinical need, and preclinical animal models are not predictive for new antitussive agents. We have investigated the mechanisms and pharmacological sensitivity of ozone-induced hypertussive responses in rabbits and guinea pigs. Ozone induced a significant increase in cough frequency and a decrease in time to first cough to inhaled citric acid in both conscious guinea pigs and rabbits. This response was inhibited by the established antitussive drugs codeine and levodropropizine. In contrast to the guinea pig, hypertussive responses in the rabbit were not inhibited by bronchodilator drugs (β2 agonists or muscarinic receptor antagonists), suggesting that the observed hypertussive state was not secondary to bronchoconstriction in this species. The ozone-induced hypertussive response in the rabbit was inhibited by chronic pretreatment with capsaicin, suggestive of a sensitization of airway sensory nerve fibers. However, we could find no evidence for a role of TRPA1 in this response, suggesting that ozone was not sensitizing airway sensory nerves via activation of this receptor. Whereas the ozone-induced hypertussive response was accompanied by a significant influx of neutrophils into the airway, the hypertussive response was not inhibited by the anti-inflammatory phosphodiesterase 4 inhibitor roflumilast at a dose that clearly exhibited anti-inflammatory activity. In summary, our results suggest that ozone-induced hypertussive responses to citric acid may provide a useful model for the investigation of novel drugs for the treatment of cough, but some important differences were noted between the two species with respect to sensitivity to bronchodilator drugs.

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Section: Discussionmentioning

confidence: 83%

Ozone-Induced Hypertussive Responses in Rabbits and Guinea Pigs

Clay¹,

Patacchini²,

Trevisani³

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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“…There was an excessive use of antibiotics in acute cough, particularly in allergic rhinitis/asthma (41%) and URTIs (17%). Moreover, despite the recent evidence that symptomatic treatments, such as either mucoactive or antitussive drugs, according to the type of cough, are more effective than antibiotics in acute cough,32,33 the antibiotic prescription still confirms widespread and likely led by patient/parent suggestions, as already verified in the primary care setting 34…”

Section: Discussionmentioning

confidence: 99%

Survey on attitudes of Italian pediatricians toward cough

Zanasi

Morcaldi

Cazzato³

et al. 2017

CEOR

Self Cite

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ContextChildren’s cough is a daily concern for most pediatricians. The management of both acute and chronic cough requires a systematic and comprehensive approach. Despite the approved protocols for management, the pediatric assessment of cough and the corresponding prescribing attitude frequently do not fit these protocols, which can be affected by parental suggestions – sometimes substantially.ObjectiveThe objective of this study was to investigate both the perception and the behavior of a representative sample of Italian pediatricians toward cough in real life.MethodsA specific questionnaire consisting of 18 questions was prepared. The questionnaire was completed by 300 pediatricians (all members of PAIDOSS: Italian National Observatory on Health of Childhood and Adolescence) who represented ~300,000 children.ResultsA vast majority of children have cough throughout the year (99.3% of respondents have cough during autumn/winter and 64.7% in spring/summer). Allergic disease is the most frequent suspected cause of chronic cough in children (53%), and this is supported by the high demand for consultations: 73% seek the opinion of allergologists, 62% of otorhinolaryngologists and only 33% of pulmonologists. The majority of pediatricians (92%) reported that they prescribe therapy in acute cough regardless of cough guidelines. Moreover, the survey pointed out the abuse of aerosol therapy (26% in acute cough and 38% in chronic cough) and of antibiotics prescription (22% in acute cough and 42% in chronic cough).ConclusionOur survey suggests that some Italian pediatricians’ therapeutic attitudes should be substantially improved in order to achieve better management of cough in children and to minimize the burden of cough.

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“…The clinical trials supporting its use in children and adults are summarised in a recent open access meta-analysis. 40 There were four studies in children and three in adults. Only two studies were placebo comparisons.…”

Section: The Efficacy Of Antitussive Drugsmentioning

confidence: 99%

Comprehensive evidence-based review on European antitussives

Morice

Kardos

2016

BMJ Open Resp Res

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Acute cough caused by viral respiratory tract infections is probably the most common illness to afflict mankind. Despite the widespread but ineffective prescribing of antibiotics, there is no specific therapy. Home remedies and over-the-counter medicines are the mainstay for treatment of this short-lived but debilitating condition where cough is a major troublesome symptom. Across Europe, there are large variations in the recommendations made by healthcare professionals for the treatment of acute cough. This has arisen through custom and practice based on the evidence of historical studies performed to standards well short of what would be considered legitimate today. Acute cough is particularly difficult to study in a controlled setting because of the high rate of spontaneous remission and a large placebo effect. Here we detail the validated modern methodology used to assess the efficacy of antitussives and review the drugs commonly used in Europe against these standards. INTRODUCTIONAcute cough is the most common symptom for which medical advice is sought. It is responsible for over 50% of new patient attendance in primary care and is the major source of consultation in pharmacy practice. Indeed, since symptomatic therapy is the mainstay of management of this generally benign and selflimiting illness, the pharmacist is the key player in the treatment of this condition.Unfortunately, much of the over-thecounter (OTC) therapy currently recommended throughout Europe is based on custom and practice and is not supported by clinical studies of sufficient quality to meet the standards of modern evidence-based medicine. Here we review the diagnosis and therapeutic options available for the treatment of what is perhaps the most common ailment to afflict mankind.

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Levodropropizine for treating cough in adult and children: a meta-analysis of published studies

Cited by 37 publications

References 13 publications

Ozone-Induced Hypertussive Responses in Rabbits and Guinea Pigs

Ozone-Induced Hypertussive Responses in Rabbits and Guinea Pigs

Survey on attitudes of Italian pediatricians toward cough

Comprehensive evidence-based review on European antitussives

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