Treatment of Unexplained Chronic Cough

Gibson, Peter G.; Wang, Gang; McGarvey, Lorcan; Vertigan, Anne E.; Altman, Kenneth W.; Birring, Surinder S.

doi:10.1378/chest.15-1496

Cited by 292 publications

(159 citation statements)

References 40 publications

Supporting

Mentioning

150

Contrasting

Unclassified

Order By: Relevance

“…Although various therapeutic approaches to patients with CC have been evaluated, there is no convincing data on the effectiveness of these www.journals.viamedica.pl VAS -visual analogue scale, range 0-100 mm; LCQ -Leicester Cough Questionnaier (LCQ), range 3-21 points; the higher the value, the better quality of life in patients with cough; C2 -concentration of capsaicin, which induce 2 coughs during provocation challenge test with capsaicin therapies, and the management of chronic cough is still challenging [4]. Our patient had been unsuccesfully treated for 18 years (1998-2016) before her cough was significantly reduced due to the speech therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The results of management of CC in adults are highly unsatisfactory [1,3,4]. It may be a result of either ineffective management of properly diagnosed underlying diseases (difficult-to-treat CC) or failure to diagnose the cause of CC.…”

Section: Introductionmentioning

confidence: 99%

“…It may be a result of either ineffective management of properly diagnosed underlying diseases (difficult-to-treat CC) or failure to diagnose the cause of CC. According to ACCP recommendations, unexplained chronic cough (UCC) is diagnosed in as many as 5-10% of all adults with CC [4]. Persistent CC significantly impairs the quality of life [5].…”

Section: Introductionmentioning

confidence: 99%

“…There are only few methods of management of patients with UCC [4]. These include pharmacological treatment with gabapentin and speech and language intervention (the other names: speech or voice therapy).…”

Section: Introductionmentioning

confidence: 99%

“…These include pharmacological treatment with gabapentin and speech and language intervention (the other names: speech or voice therapy). The latter is the most documented method of management of UCC or difficult-to-treat cough [4]. Speech therapy consists of education, learning strategies to reduce cough, respiratory and speech exercises [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Speech Therapy—A Non-Pharmacological Method to Manage Difficult-to-treat Chronic Cough

Krakowiak

Dąbrowska

Buła

et al. 2017

Advances in Respiratory Medicine

View full text Add to dashboard Cite

Cough is the most common symptom of respiratory diseases. The results of management of chronic cough in adults are still unsatisfactory. Unexplained and difficult-to-treat chronic cough causes significant impairment in patients' quality of life. The results of recent studies suggest that speech therapy (speech language intervention) is one of the few methods which are usefull in management of persistent chronic cough. We present a case of a patient with chronic cough due to chronic nonallergic rhinitis and gastroesophageal reflux disease, who had been unsuccessfully treated for 18 years. In the patient speech therapy resulted in a significant decrease of cough severity and improvement of quality of life.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Speech Therapy—A Non-Pharmacological Method to Manage Difficult-to-treat Chronic Cough

Krakowiak

Dąbrowska

Buła

et al. 2017

Advances in Respiratory Medicine

View full text Add to dashboard Cite

show abstract

Efficacy and Tolerability of Gefapixant for Treatment of Refractory or Unexplained Chronic Cough

Kum,

Patel,

Diab

et al. 2023

JAMA

View full text Add to dashboard Cite

ImportanceGefapixant represents an emerging therapy for patients with refractory or unexplained chronic cough.ObjectiveTo evaluate the efficacy and tolerability of gefapixant for the treatment of adults with refractory or unexplained chronic cough.Data SourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from November 2014 to July 2023.Study SelectionTwo reviewers independently screened for parallel and crossover randomized clinical trials (RCTs) that compared, in patients with refractory or unexplained chronic cough, either gefapixant with placebo, or 2 or more doses of gefapixant with or without placebo.Data Extraction and SynthesisTwo reviewers independently extracted data. A frequentist random-effects dose-response meta-analysis or pairwise meta-analysis was used for each outcome. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in whether patients would perceive the effects as important (greater than the minimal important difference [MID]) or small (less than the MID).Main Outcomes and MeasuresCough frequency (measured using the VitaloJAK cough monitor; MID, 20%), cough severity (measured using the 100-mm visual analog scale [VAS]; higher score is worse; MID, 30 mm), cough-specific quality of life (measured using the Leicester Cough Questionnaire [LCQ]; score range, 3 [maximal impairment] to 21 [no impairment]; MID, 1.3 points), treatment-related adverse events, adverse events leading to discontinuation, and taste-related adverse events.ResultsNine RCTs including 2980 patients were included in the primary analysis. Compared with placebo, gefapixant (45 mg twice daily) had small effects on awake cough frequency (17.6% reduction [95% CI, 10.6%-24.0%], moderate certainty), cough severity on the 100-mm VAS (mean difference, −6.2 mm [95% CI, −4.1 to −8.4]; high certainty), and cough-specific quality of life on the LCQ (mean difference, 1.0 points [95% CI, 0.7-1.4]; moderate certainty). Compared with placebo, gefapixant (45 mg twice daily) probably caused an important increase in treatment-related adverse events (32 more per 100 patients [95% CI, 13-64 more], moderate certainty) and taste-related adverse events (32 more per 100 patients [95% CI, 22-46 more], high certainty). High-certainty evidence suggests that gefapixant (15 mg twice daily) had small effects on taste-related adverse events (6 more per 100 patients [95% CI, 5-8 more]).Conclusions and RelevanceCompared with placebo, gefapixant (45 mg orally twice daily) led to modest improvements in cough frequency, cough severity, and cough-specific quality of life but increased taste-related adverse events.

show abstract

Codeine versus placebo for chronic cough in children

Gardiner

Chang

Marchant

et al. 2016

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

This review has highlighted the absence of any randomised controlled trials evaluating codeine-based medications in the treatment of childhood chronic cough. Given the potential adverse events of respiratory suppression and opioid toxicity, national therapeutic regulatory authorities recommend the contraindication of access to codeine in children less than 12 years of age. We suggest that clinical practice adhere to clinical practice guidelines and thus refrain from using codeine or its derivatives to treat cough in children. Aetiological-based management practices continue to be advocated for children with chronic cough.

show abstract

Treatment of Unexplained Chronic Cough

Abstract: on behalf of the CHEST Expert Cough Panel BACKGROUND: Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC.

Cited by 292 publications

References 40 publications

Speech Therapy—A Non-Pharmacological Method to Manage Difficult-to-treat Chronic Cough

Speech Therapy—A Non-Pharmacological Method to Manage Difficult-to-treat Chronic Cough

Efficacy and Tolerability of Gefapixant for Treatment of Refractory or Unexplained Chronic Cough

Codeine versus placebo for chronic cough in children

Contact Info

Product

Resources

About