Antireflux treatment is linked to chronic cough relief

  • Takeda N & al.
  • J Asthma
  • 15 jul. 2019

  • de Craig Hicks
  • Clinical Essentials
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Takeaway

  • Antireflux treatment appears to provide significant relief to patients with chronic, gastroesophageal reflux disease (GERD)-associated cough.

Why this matters

  • GERD is a common cause of chronic cough.

Study design

  • Researchers studied patients with suspected GERD-associated cough (n=37; mean age, 53.6±14.9 years; 54% women) based on symptoms including heartburn and absence of rhinitis, sinusitis, or postnasal drip.
  • They used patient questionnaires, laboratory analysis of blood and sputum, pulmonary function tests, and endoscopic assessments both before and after 4 weeks of antireflux treatment with the proton pump inhibitor rabeprazole (Aciphex) 20 mg daily and the prokinetic agent itopride (Ganaton) 50 mg 3 times per day.
  • Funding: Ministry of Education, Culture, Sports, Science and Technology of Japan.

Key results

  • Patient cough symptoms improved after antireflux treatment (P<.0001 with significant correlation between changes in subjective measures of cough severity and acid reflux symptoms p>
  • Researchers found significant positive correlations in all patients between baseline plasma substance P (SP) and sputum neutrophils levels (r=0.46; P=.048) and between decreases in plasma SP and sputum SP levels (r=0.46; P=.049).

Limitations

  • The study was single-center and observational with a small sample size.