People who suffer from chronic cough have been given cause for optimism thanks to a drug that can ease the symptom.
Researchers suggest the medication called gefapixant has the potential to have a significant impact on the lives of thousands of sufferers.
Chronic coughing is defined as lasting for more than eight weeks, and is thought to affect between 4% and 10% of the UK population, some of whom cough thousands of times a day over many years.
Although many patients improve with treatment of associated conditions such as asthma, gastroesophageal reflux disease and nasal disease, many others are less fortunate.
As well as a distressing cough, the condition can also cause abdominal pain, urinary incontinence in women, as well as anxiety, depression and difficulty sleeping.
The new study reports on the world’s first late stage clinical trials, which have shown the drug can ease the chronic cough with few side effects.
Principal researcher Jacky Smith, professor of respiratory medicine at The University of Manchester, said: “These global trials have confirmed that this drug has exciting potential for patients who suffer from chronic cough, an often distressing condition.
“Effective treatments for cough are a significant unmet clinical need and no new therapies have been 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. The coughing interferes with conversations, sometimes it stops me singing which I love to do.
“It’s embarrassing when I’m with people – I find myself apologizing a lot, and I have no control over it. 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.”
Two clinical trials that lasted for a year – called Cough 1 and Cough 2 – involved 2,044 people from 17 countries who had suffered from chronic cough for an average of 11 years.
In the Cough 1 trial, 730 people were given either a 45mg dose of gefapixant, 15mg or a placebo, whilst in the Cough 2 trial, 1,314 patients were given either a 45mg dose of gefapixant, 15mg or a placebo.
The study, published in The Lancet found that the larger dose of the drug demonstrated an 18.5% reduction in how often people coughed in 24 hours in Cough 1 in versus the placebo, and a 14.6% reduction in Cough 2. In both studies the drug resulted in a reduction in coughing for up to six months, the research suggests.
The 15mg dose did not demonstrate a significant reduction in cough frequency versus the placebo. The drug, which is being developed in collaboration with the pharmaceutical company MSD, who funded the trials, was initially developed as a painkiller, until the researchers discovered it had a significant impact on chronic cough.
Professor Smith added: “We can’t say this drug is a cure for chronic cough, but it can and often does reduce the frequency of coughing substantially. Now these phase 3 trials have been successful, we feel this is a major step towards this treatment becoming available for our patients with chronic cough.
“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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