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Chronic cough and esomeprazole: A double-blind placebo-controlled parallel study

MORICE, ALYN H.; MOLYNEUX, IAN D.; Morice, Alyn; Faruqi, Shoaib; Thompson, Rachel; Molyneux, Ian D.; Fathi, Hosnieh; Wright, Caroline; Molyneux, Ian; Thompson, Rachael; Morice, Alyn H.

Authors

ALYN H. MORICE

IAN D. MOLYNEUX

Alyn Morice

Shoaib Faruqi

Rachel Thompson

Ian D. Molyneux

Hosnieh Fathi

Caroline Wright

Ian Molyneux

Rachael Thompson

Alyn H. Morice



Abstract

Background and objective: Gastro-oesophageal reflux has been implicated in the pathogenesis of chronic cough. Guidelines on management suggest a therapeutic trial of anti-reflux medication. Esomeprazole is a proton pump inhibitor licensed for the long-term treatment of acid reflux in adults and we compared the effects of esomeprazole and placebo on patients with chronic cough. Methods: This was a prospective, single-centre, randomized, double-blind, placebo-controlled, parallel group study conducted over 8 weeks. Fifty adult non-smokers with chronic cough and normal spirometry were randomized. Patients completed cough-related quality-of-life and symptom questionnaires and subjective scores of cough frequency and severity at the beginning and end of the study. They also kept a daily diary of symptom scores. Citric acid cough challenge and laryngoscopic examination were performed at baseline and the end of the study. The primary outcome was improvement in cough score. Results: There were no differences in cough scores in the placebo and treatment arms of the study although some significant improvements were noted when compared to baseline. In the cough diary scores there was a trend towards greater improvement in the treatment arm in patients with dyspepsia. Conclusions: Esomeprazole did not have a clinically important effect greater than placebo in patients with cough. It suggests a marked placebo effect in the treatment of cough. There is paucity of evidence on which to base the treatment of reflux-associated cough. We demonstrate that acid suppressive therapy does not lead to a significant clinical effect in these patients. There may be some improvement in those with coexisting dyspeptic symptoms and therapy should be restricted to this group. © 2011 Asian Pacific Society of Respirology.

Citation

Faruqi, S., Molyneux, I. D., Fathi, H., Wright, C., Thompson, R., & Morice, A. H. (2011). Chronic cough and esomeprazole: A double-blind placebo-controlled parallel study. Respirology : official journal of the Asian Pacific Society of Respirology, 16(7), 1150-1156. doi:10.1111/j.1440-1843.2011.02014.x

Journal Article Type Article
Online Publication Date Sep 26, 2011
Publication Date Oct 1, 2011
Deposit Date Nov 13, 2014
Publicly Available Date Nov 23, 2017
Journal Respirology
Print ISSN 1323-7799
Electronic ISSN 1440-1843
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 16
Issue 7
Pages 1150-1156
DOI https://doi.org/10.1111/j.1440-1843.2011.02014.x
Keywords Pulmonary and Respiratory Medicine
Public URL https://hull-repository.worktribe.com/output/473253
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1843.2011.02014.x/abstract;jsessionid=CFF4B2AB5A8DA236351D0D8D4916DB60.f04t04
Copyright Statement ©2016 University of Hull
Additional Information Authors' accepted manuscript of article published in: Respirology, 2011, v.16, issue 7

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