Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial
Abstract Objective The purpose of this study was to collect pilot efficacy data on a novel treatment for refractory chronic cough (RCC), which we call cough desensitization treatment (CDT). Design and methods In this parallel cohort, sham-controlled, randomized controlled trial, 21 adults with RCC w...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02423-6 |
| _version_ | 1797836615634124800 |
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| author | Laurie J. Slovarp Jane E. Reynolds Sophia Tolbert Sarah Campbell Shannon Welby Paige Morkrid |
| author_facet | Laurie J. Slovarp Jane E. Reynolds Sophia Tolbert Sarah Campbell Shannon Welby Paige Morkrid |
| author_sort | Laurie J. Slovarp |
| collection | DOAJ |
| description | Abstract Objective The purpose of this study was to collect pilot efficacy data on a novel treatment for refractory chronic cough (RCC), which we call cough desensitization treatment (CDT). Design and methods In this parallel cohort, sham-controlled, randomized controlled trial, 21 adults with RCC were randomly assigned to 12 sessions of either CDT (progressive doses of aerosolized capsaicin while behaviorally suppressing cough; n = 11) or a sham treatment (repeated exposure to aerosolized saline; n = 9). The Leicester Cough Questionnaire (LCQ) was the primary outcome measure. Perceived cough severity with a visual analogue scale and cough challenge testing (for measuring cough-reflex sensitivity) were secondary outcome measures. Data were analyzed with mixed effects linear regression and follow-up contrasts. Results Results on all measures favored CDT. Excluding one sham participant, whose baseline LCQ scores were deemed unreliable, mean change in LCQ at 3-weeks post treatment was 6.35 and 2.17 in the CDT and sham groups, respectively. There was moderate to strong evidence of a greater improvement in the CDT group in total LCQ score (p = .058) and LCQ Psychological domain (p = .026) and Physical domain (p = .045) scores. Strong evidence was found for a greater reduction in urge-to-cough during CCT in the CDT group (p = .037) and marginal for a reduction in the capsaicin cough-reflex sensitivity (p = .094). There was weak evidence of a greater reduction in cough severity in the CDT group (p = .103). Discussion Although the study is limited due to the small sample size, the data provide additional evidence supporting further research on CDT. CDT resulted in a greater change in the primary efficacy measure (LCQ) than both pharmaceutical and behavioral treatments currently found in the literature. Trial Registration This trial (NCT05226299) was registered on Clinicaltrials.gov on 07/02/2022. |
| first_indexed | 2024-04-09T15:12:52Z |
| format | Article |
| id | doaj.art-692d41178d2848478afb06f6a92c8222 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-09T15:12:52Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-692d41178d2848478afb06f6a92c82222023-04-30T11:06:07ZengBMCBMC Pulmonary Medicine1471-24662023-04-0123111310.1186/s12890-023-02423-6Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trialLaurie J. Slovarp0Jane E. Reynolds1Sophia Tolbert2Sarah Campbell3Shannon Welby4Paige Morkrid5University of Montana, School of Speech, Language, Hearing, & Occupational SciencesUniversity of Montana, School of Speech, Language, Hearing, & Occupational SciencesUniversity of Montana, School of Speech, Language, Hearing, & Occupational SciencesUniversity of Montana, School of Speech, Language, Hearing, & Occupational SciencesUniversity of Montana, School of Speech, Language, Hearing, & Occupational SciencesUniversity of Montana, School of Speech, Language, Hearing, & Occupational SciencesAbstract Objective The purpose of this study was to collect pilot efficacy data on a novel treatment for refractory chronic cough (RCC), which we call cough desensitization treatment (CDT). Design and methods In this parallel cohort, sham-controlled, randomized controlled trial, 21 adults with RCC were randomly assigned to 12 sessions of either CDT (progressive doses of aerosolized capsaicin while behaviorally suppressing cough; n = 11) or a sham treatment (repeated exposure to aerosolized saline; n = 9). The Leicester Cough Questionnaire (LCQ) was the primary outcome measure. Perceived cough severity with a visual analogue scale and cough challenge testing (for measuring cough-reflex sensitivity) were secondary outcome measures. Data were analyzed with mixed effects linear regression and follow-up contrasts. Results Results on all measures favored CDT. Excluding one sham participant, whose baseline LCQ scores were deemed unreliable, mean change in LCQ at 3-weeks post treatment was 6.35 and 2.17 in the CDT and sham groups, respectively. There was moderate to strong evidence of a greater improvement in the CDT group in total LCQ score (p = .058) and LCQ Psychological domain (p = .026) and Physical domain (p = .045) scores. Strong evidence was found for a greater reduction in urge-to-cough during CCT in the CDT group (p = .037) and marginal for a reduction in the capsaicin cough-reflex sensitivity (p = .094). There was weak evidence of a greater reduction in cough severity in the CDT group (p = .103). Discussion Although the study is limited due to the small sample size, the data provide additional evidence supporting further research on CDT. CDT resulted in a greater change in the primary efficacy measure (LCQ) than both pharmaceutical and behavioral treatments currently found in the literature. Trial Registration This trial (NCT05226299) was registered on Clinicaltrials.gov on 07/02/2022.https://doi.org/10.1186/s12890-023-02423-6Chronic coughRefractory chronic coughCough hypersensitivityLeicester Cough QuestionnaireCough suppressionCapsaicin |
| spellingShingle | Laurie J. Slovarp Jane E. Reynolds Sophia Tolbert Sarah Campbell Shannon Welby Paige Morkrid Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial BMC Pulmonary Medicine Chronic cough Refractory chronic cough Cough hypersensitivity Leicester Cough Questionnaire Cough suppression Capsaicin |
| title | Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial |
| title_full | Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial |
| title_fullStr | Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial |
| title_full_unstemmed | Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial |
| title_short | Cough desensitization treatment for patients with refractory chronic cough: results of a second pilot randomized control trial |
| title_sort | cough desensitization treatment for patients with refractory chronic cough results of a second pilot randomized control trial |
| topic | Chronic cough Refractory chronic cough Cough hypersensitivity Leicester Cough Questionnaire Cough suppression Capsaicin |
| url | https://doi.org/10.1186/s12890-023-02423-6 |
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