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26.02.20

New treatment offers hope for people suffering with chronic cough

Researchers at the University of Manchester may be able to offer hope to millions suffering from a chronic cough, after a new study revealed a new treatment which would relieve their debilitating symptoms.

Carrying out a 12-week clinical trial of 253 men and women from the US and UK who had suffered a cough, but were otherwise healthy, that had been unresponsive to treatment for an average of 14.5 years, researchers saw a new drug resulted in a significant reduction in patients’ symptoms.

Up to 10% of adults worldwide experience symptoms with no clear underlying cause, with some suffering for decades. Currently, there is no effective treatment.

Patients in the clinical trial were either given a placebo or a potential new drug, Gefapixant (MK-7264), twice a day for 84 days but were not told which. The drug was administered in doses of either 7.5mg, 20mg or 50mg.

Before the trial, patients reported coughing around 24-29 times per hour.

Following 12 weeks of treatment, those being given the drug reported a reduction to, on average, 11 coughs per hour. However, researchers also noted those taking a placebo also reported a reduction, down to an average of 18 coughs per hour.

Professor Jacky Smith, Principle Researcher for the study, a Professor of Respiratory Medicine at the University of Manchester and a consultant at Wythenshawe Hospital, said: “This drug has exciting prospects for patients who suffer from the often distressing condition of chronic cough.

“Effective treatments for cough are a significant unmet clinical need and no new therapies approved in over 50 years.

“Billions of pounds are spent annually on over-the-counter cough and cold medicines despite a lack of evidence to support their efficacy, concerns about the potential for abuse and risk of harm in overdose.”

While patients not taking the drug also saw a benefit, Professor Smith suggested this placebo effect may have been the result of patients being aware that previous studies with the drug had recorded positive effects.

Gefapixant is able to target P2X3receptors in the nerves which control coughing, with the team monitoring the impact of the drug using a special cough-monitoring device they developed to count individual coughs.

The drug had initially been developed as a pain killer until researchers discovered it had a significant impact on chronic cough.

Some unlicensed drugs have previously also been shown to improve chronic cough but, due to unpleasant side effects, their use has been limited. It is thought a chemical called adenosine triphosphate (ATP), released as a response to inflammation in airways, may be an important mechanism for patients with chronic cough.

Professor Smith added: “We can’t yet say when or if this drug will be available on prescription, however, if the phase 3 trial is successful then it would certainly be a major step towards everyday use.

“Though it’s fair to say the drug is not a cure for chronic cough, it can and often does reduce the frequency of coughing substantially”

“That could make a big difference to patients who often struggle with this condition which can make such a big impact on their lives.”

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