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What you need to know
Chronic cough is a common problem, particularly in women, with peak prevalence in those aged 50–70 years.
Patients with chronic cough should be assessed for any red flag clinical features and potentially treatable causes.
Gefapixant is licensed for the treatment of refractory or unexplained chronic cough in adults.
In the two main licensing studies, gefapixant produced only a small additional effect over placebo in reducing the number of coughs over 24 hours.
The most frequently reported adverse reactions with gefapixant compared with placebo were disorders of taste with 32 additional taste-related adverse events per 100 people.
Introduction
Cough is a protective reflex to prevent aspiration into the lung and to enhance airway clearance.1 2 Cough is partly under voluntary control through conscious and unconscious mechanisms and may be triggered by thermal, mechanical or chemical stimuli via different sensory neurons on the vagus nerve.1 3–5
Cough in adults can be classified as acute (<3 weeks), subacute (3–8 weeks) or chronic (>8 weeks).6 Chronic cough can result from many conditions and although it has been suggested that as many as 10% of adults may experience chronic cough, UK primary care studies suggest a prevalence of 1%–2%.2 The peak prevalence is in people in their 50s and 60s and two-thirds of those with chronic cough are women.2 4 7 Chronic cough is associated with complications that include sleep disturbance, dysphonia, fatigue, reduced quality of life, stress urinary incontinence, depression, anxiety, headaches and social isolation.2 7
Management of chronic cough
Clinical guidelines state that patients presenting with chronic cough should be evaluated for potentially treatable causes (eg, smoking, infection, drugs known to cause cough, asthma, gastro-oesophageal reflux disease [GORD], postnasal drip).2 6–8 In addition, the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries recommend that a full history should …
Footnotes
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Provenance and peer review Commissioned; externally peer-reviewed.