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A drug could be a game-changer for people with chronic cough | Health policy


A new chronic cough drug could be a game-changer for thousands of Britons who cough uncontrollably many times a day.

Leading pulmonologist Surinder Biring led a world court Gefapixant has been found to reduce cough in humans by up to 60% and provide relief in 70% of those who take it.

Biring, a professor of respiratory medicine at King’s College Hospital in London, said that if approved, the experimental drug would be the first new treatment in more than 50 years to ease the symptoms of the debilitating condition.

A chronic or persistent cough is defined as a cough that lasts for more than eight weeks. Between 4% and 12% of people in the UK suffer from it, lung specialists estimate. In many cases, this is because they have asthma, chronic obstructive pulmonary disease, or another condition that seriously affects their breathing. But for others, their cough has no obvious medical explanation.

“If Gefapixant becomes available, it could be a game-changer in respiratory medicine,” Biring told the Guardian.

“This is a very effective treatment that works in most patients with chronic cough. It has been found to be safe and effective in clinical trials. This is a great advance in the field of cough treatment.

“This could be the first new drug approved in more than 50 years. There are potentially thousands and thousands of patients who are suitable for this treatment.’

People who suffer from chronic cough often have a very limited social life because they avoid gatherings when their constant coughing annoys the people around them. Many also become anxious, depressed, or both. It can disturb one’s sleep and cause a cough so severe that it results in muscle and rib pain. Some people also pass out, vomit, or experience headaches as a result of severe coughing.

“We found that the frequency of coughing with Gefapixant was reduced by 60%. People slept better, had less chest pain, were less tired, and were more able to go about their lives. This resulted in a clinically significant improvement in quality of life in approximately 70% of patients treated with Gefapixant. This is very good news for patients,” Biring added.

The drug has been approved in Switzerland and Japan and is already being used in both countries. The US Federal Drug Administration has begun testing the drug. It must be licensed by the Medicines and Healthcare Products Regulatory Agency (MHRA) before UK residents can access it.

Biring was the principal investigator of one of two international trials of the drug, conducted respectively in 20 and 17 countries, including the UK, involving more than 2,000 patients. In the trials, participants were given 15 mg or 45 mg of gefapixant twice daily or a placebo.

All participating patients had a “persistent” — or unexplained — chronic cough. Two-thirds of those who suffer from a chronic cough are women, and it often does not develop until a person is in their 50s.

According to the results, which were published earlier this year in The Lancet, researchers found that taking two 45g doses resulted in a “significant reduction in 24-hour cough frequency” compared to placebo.

Biring explained that chronic coughs are caused by hypersensitivity of sensory nerves in their airways, which can be stimulated by temperature, humidity or polluted air.

Half of the trial participants either found that their sense of taste was either affected or completely gone when they took the drug. However, most decided that this side effect was “a price worth paying” for the significant drop in coughing, Beering added.

The charity Asthma and Lung UK welcomed the trial results.

“This promising research could pave the way for the development of a new treatment for chronic cough,” said Dr Erica Kennington, Head of Research and Innovation.

“Many have experienced a severe cough for days or weeks. But in other people, the cough continues even though no reason has been found after extensive investigation.

“Some people find it difficult to sleep through the night without waking up coughing, and may even cough so hard that it causes severe pain in their ribs and muscles.”

New treatments for people with long-term respiratory symptoms are rare because the government funds too little research into such conditions, she added.

“I cough 45 times an hour – I want peace”

64-year-old singer Patty Harris talks about how seriously a chronic cough, which she has had for 27 years, is affecting her life.

My persistent cough started in 1995. Then I came down with the flu, and the cough I had then never went away. It’s a pain, really. King’s College Hospital in London, where I am a patient, measured how often I cough and found that I cough 45 times an hour, or about 660 times a day, but not at night.

It is not very pleasant to cough all the time. It affects my daily life, about eight or nine times out of ten, I would say. It is very unpleasant and it is also very tiring to cough all the time. Constant cough is a very unpleasant disease.

It’s also tiring because you can’t do anything other people do, like go to the movies or the theater, if your cough is bothering people. So I have a very limited social life. When I go to a movie or play, I always reserve a seat at the end of the row, just in case I have to leave. When I go to a restaurant, if I eat something spicy like a curry or something with chili, the first bite of it makes me cough and it’s really embarrassing.

The only way I can suppress my cough is to use strong painkillers, although this is not reliable. So when I’m performing – I’ve been singing all my life – I take two Coca-Cola pills an hour before I go on stage. Sometimes I also give alcohol as it can also help suppress the cough. But if I do, I pay for it the next day because I often feel nauseous and sick.

It could have been worse. I know some people who never leave their house because of bad cough. It’s so sad.

I have read all the medical papers on cough and potential treatments because I am desperate to find something that will help me. I want peace before I die! I want to be able to go out somewhere and not be embarrassed, and not have to dose myself up with painkillers. I tried various treatments, including epilepsy medication, but they didn’t help.

I am hoping that Gefapixant and some of the other chronic cough drugs that are just being tried will work. People like me are desperate for a treatment that actually works.”

As told by Denis Campbell


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