Randomised clinical trial: high-dose acid suppression for chronic cough - a double-blind, placebo-controlled study.

Abstract

BACKGROUND:

Cough may be a manifestation of gastro-oesophageal reflux disease (GERD). The utility of acid suppression in GERD-related cough is uncertain.

AIM:

To assess the impact of high-dose acid suppression with proton pump inhibitors (PPI) on chronic cough in subjects with rare or no heartburn.

METHODS:

Subjects were nonsmokers without history of asthma, with chronic cough for >8 weeks. All subjects underwent a baseline 24-h pH/impedance study, methacholine challenge test and laryngoscopy. Subjects were randomised to either 40 mg of esomeprazole twice daily or placebo for 12 weeks. The primary outcome measure was the Cough-Specific Quality of Life Questionnaire (CQLQ). Secondary outcomes were response on Fisman Cough Severity/Frequency scores and change in laryngeal findings.

RESULTS:

Forty subjects were randomised (22 PPI, 18 placebo) and completed the study. There was no difference between PPI and placebo in CQLQ (mean improvement 9.8 vs. 5.9 respectively, P = 0.3), or Fisman Cough Severity/Frequency scores. Proportion of patients who improved by >1 s.d. on the CQLQ was 27.8% (five of 18) and 31.8% (seven of 22) in the placebo and PPI groups respectively.

CONCLUSION:

In subjects with chronic cough and rare or no heartburn, high-dose proton pump inhibitor does not improve cough-related quality of life or symptoms.

• Authors: N J Shaheen, S D Crockett, S D Bright, R D Madanick, R Buckmire, M Couch, E S Dellon, J A Galanko, G Sharpless, D R Morgan, M B Spacek, P Heidt-Davis, D Henke
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 33 Issue 2 Pg. 225-34 (Jan 2011) ISSN: 1365-2036 [Electronic] England
• PMID: 21083673 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 Blackwell Publishing Ltd.

Chemical References

• Proton Pump Inhibitors
• Esomeprazole

Topics

• Adolescent
• Adult
• Aged
• Chronic Disease
• Cough (complications, drug therapy)
• Double-Blind Method
• Esomeprazole (therapeutic use)
• Female
• Gastroesophageal Reflux (complications, drug therapy)
• Humans
• Male
• Middle Aged
• Proton Pump Inhibitors (therapeutic use)
• Severity of Illness Index
• Statistics as Topic
• Treatment Outcome
• Young Adult