Chronic cough: is the end nigh?
Chronic cough (lasting more than 8 weeks) is a common condition with substantial psychosocial impact. Despite huge efforts following robust guidelines, chronic cough in many patients remains refractory or unexplained (RU-CC). Recent insights support a significant role for cough hypersensitivity in R...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
European Respiratory Society
2024-02-01
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Series: | Breathe |
Online Access: | http://breathe.ersjournals.com/content/19/4/230165.full |
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author | Barnaby Hirons Richard Turner Peter S.P. Cho Surinder S. Birring |
author_facet | Barnaby Hirons Richard Turner Peter S.P. Cho Surinder S. Birring |
author_sort | Barnaby Hirons |
collection | DOAJ |
description | Chronic cough (lasting more than 8 weeks) is a common condition with substantial psychosocial impact. Despite huge efforts following robust guidelines, chronic cough in many patients remains refractory or unexplained (RU-CC). Recent insights support a significant role for cough hypersensitivity in RU-CC, including neuropathophysiological evidence from inhalational cough challenge testing, functional magnetic resonance imaging, and airway nerve biopsy. Along with improved approaches to measuring cough, this knowledge has developed in tandem with repurposing neuromodulator medications, including gabapentin, and evidence for non-pharmacological treatments. Most significantly, there is now a pipeline for novel classes of drugs specifically for chronic cough. The P2X3 receptor antagonist gefapixant is the first such drug to be approved in Europe. However, challenges persist. The field of chronic cough needs more robust epidemiological data, enhanced diagnostic tools, further well-designed clinical trials accounting for the effects of placebo, and treatments with minimal side-effects. Addressing these challenges are novel chronic cough registries, improved International Classification of Diseases (10th revision) coding, genetic testing options and further mechanistic studies. This Viewpoint article discusses these facets and considers how, whilst the end of chronic cough may not be imminent for all patients, the evolving landscape looks increasingly optimistic. |
first_indexed | 2024-03-07T21:20:42Z |
format | Article |
id | doaj.art-307c029d3d34425fbc1e2db18340808d |
institution | Directory Open Access Journal |
issn | 1810-6838 2073-4735 |
language | English |
last_indexed | 2024-03-07T21:20:42Z |
publishDate | 2024-02-01 |
publisher | European Respiratory Society |
record_format | Article |
series | Breathe |
spelling | doaj.art-307c029d3d34425fbc1e2db18340808d2024-02-27T11:58:25ZengEuropean Respiratory SocietyBreathe1810-68382073-47352024-02-0119410.1183/20734735.0165-20230165-2023Chronic cough: is the end nigh?Barnaby Hirons0Richard Turner1Peter S.P. Cho2Surinder S. Birring3 Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, King's College London, London, UK Department of Respiratory Medicine, Gold Coast University Hospital, Queensland, Australia Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, King's College London, London, UK Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, King's College London, London, UK Chronic cough (lasting more than 8 weeks) is a common condition with substantial psychosocial impact. Despite huge efforts following robust guidelines, chronic cough in many patients remains refractory or unexplained (RU-CC). Recent insights support a significant role for cough hypersensitivity in RU-CC, including neuropathophysiological evidence from inhalational cough challenge testing, functional magnetic resonance imaging, and airway nerve biopsy. Along with improved approaches to measuring cough, this knowledge has developed in tandem with repurposing neuromodulator medications, including gabapentin, and evidence for non-pharmacological treatments. Most significantly, there is now a pipeline for novel classes of drugs specifically for chronic cough. The P2X3 receptor antagonist gefapixant is the first such drug to be approved in Europe. However, challenges persist. The field of chronic cough needs more robust epidemiological data, enhanced diagnostic tools, further well-designed clinical trials accounting for the effects of placebo, and treatments with minimal side-effects. Addressing these challenges are novel chronic cough registries, improved International Classification of Diseases (10th revision) coding, genetic testing options and further mechanistic studies. This Viewpoint article discusses these facets and considers how, whilst the end of chronic cough may not be imminent for all patients, the evolving landscape looks increasingly optimistic.http://breathe.ersjournals.com/content/19/4/230165.full |
spellingShingle | Barnaby Hirons Richard Turner Peter S.P. Cho Surinder S. Birring Chronic cough: is the end nigh? Breathe |
title | Chronic cough: is the end nigh? |
title_full | Chronic cough: is the end nigh? |
title_fullStr | Chronic cough: is the end nigh? |
title_full_unstemmed | Chronic cough: is the end nigh? |
title_short | Chronic cough: is the end nigh? |
title_sort | chronic cough is the end nigh |
url | http://breathe.ersjournals.com/content/19/4/230165.full |
work_keys_str_mv | AT barnabyhirons chroniccoughistheendnigh AT richardturner chroniccoughistheendnigh AT peterspcho chroniccoughistheendnigh AT surindersbirring chroniccoughistheendnigh |