New treatment may help chronic cough sufferers

A new treatment may be able to help thousands of people suffering from chronic cough.

Two trials of the drug Gefapixant show how it is able to treat the symptoms of chronic cough when taken at low doses.

Principle researcher Jacky Smith, professor of Respiratory Medicine at The University of Manchester and a consultant at Wythenshawe Hospital, says Gefapixant has the potential to have a significant impact on the lives of thousands of suffers.

The drug was initially developed as a painkiller, but research shows it is able to affect nerves in the body which control coughing. The team at the University of Manchester monitored the impact of the drug using a special cough monitoring device which counts the number of times a person coughs.

A randomised, double-blind study published in Lancet Respiratory Medicines showed how during a 12-week trial of 253 patients, 80% had a clinically significant response to a dose of 50mg.

A lower dose of 7.5mg reduced coughing by 52%, where higher doses of 20mg and 50mg reduced coughing by 52% and 67% respectively. The study was the largest of its kind, though around a quarter of participants didn’t respond to the drug.

More so, another study of 57 patients published in the European Respiratory Journal showed that as little as 30mg of Gefapixant could be effective.

Higher doses of the drug do show, however, that it can reduce the sense of taste, the researchers state.

The drug is being developed in collaboration with the pharmaceutical company MSD and is now in two larger global phase 3 trials.

Chronic coughing affects between 4-10% of the population, with certain patients coughing thousands of time a day. The condition can cause abdominal pain, urinary incontinence in women, as well as anxiety and difficulty sleeping.

Professor Smith 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.”

Retired journalist Nick Peake, from Warrington, who was a television director at ITV and the BBC, has been suffering from chronic cough for 25 years.

 He said: “Coughing has blighted my life: every day without fail I cough for the first two hours, soon after I wake up often every 30 seconds. It wears me out. It comes and goes through the day: usually after a meal, or when I have a change of atmosphere - out of warm into cold, or if I exercise too hard.

 “It often stops me getting to sleep at night, but then I might wake up at 3 or 4 in the morning and start coughing. So I’m often in despair about it and it can make me miserable. How my wife has put up with it all this time I don’t know.

“It’s been going on for so long and I’m thoroughly fed up with it, and desperate for a cure to be found.”

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.”