Gefapixant Effective treatment option for Chronic Cough

Chronic cough can be a challenging condition to manage, especially when it doesn't respond to conventional treatments. In the search for new therapies, gefapixant has emerged as a potential option for patients with refractory or unexplained chronic cough. A recent systematic review and meta-analysis published in JAMA Network by Elena Kum and colleagues aimed to evaluate the efficacy and tolerability of gefapixant in this patient population.

● Study Selection: The researchers analysed data from nine randomised clinical trials involving 2,980 patients with refractory or unexplained chronic cough.

● Gefapixant at a dose of 45 mg orally twice daily led to a 17.6% reduction in awake cough frequency compared to a placebo (moderate certainty).

● Cough severity, measured using a 100-mm visual analog scale, showed a significant improvement with gefapixant, with a mean difference of -6.2 mm (high certainty).

● Cough-specific quality of life, assessed with the Leicester Cough Questionnaire, improved by 1.0 point (moderate certainty).

Tolerability:

● Gefapixant, at a dose of 45 mg twice daily, was associated with an increase in treatment-related adverse events (moderate certainty).

● Taste-related adverse events were also more common with gefapixant at this dose (high certainty).

● Overall, gefapixant demonstrated modest improvements in cough frequency, cough severity, and cough-specific quality of life in patients with refractory or unexplained chronic cough. However, it was associated with an increase in taste-related adverse events.

These findings suggest that gefapixant may offer a potential therapeutic option for individuals with chronic cough who have not responded to other treatments. Clinicians should weigh the benefits and risks of this medication when considering it for their patients.

Reference:

Kum, E., Patel, M., Diab, N., Wahab, M., Zeraatkar, D., Chu, D. K., O’Byrne, P. M., Guyatt, G. H., & Satia, I. (2023). Efficacy and tolerability of gefapixant for treatment of refractory or unexplained chronic cough: A systematic review and dose-response meta-analysis. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.2023.18035