Randomised clinical trial: gabapentin vs baclofen in the treatment of suspected refractory gastro-oesophageal reflux-induced chronic cough.

Abstract

BACKGROUND:

Neuromodulators are considered potential therapeutic options for refractory gastro-oesophageal reflux-induced chronic cough.

AIM:

To compare the efficacy of gabapentin and baclofen in patients with suspected refractory gastro-oesophageal reflux-induced chronic cough.

METHODS:

Two hundred and thirty-four patients with suspected refractory gastro-oesophageal reflux-induced chronic cough, who failed an 8-week course of omeprazole and domperidone, were recruited into the open-labelled study and randomly assigned to receive either gabapentin (maximum daily dose of 900 mg) or baclofen (maximum daily dose of 60 mg) for 8 weeks as add-on therapy to the previous treatment. The primary end point was the successful rate of cough resolution; and the secondary end-points included cough sensitivity to capsaicin and gastro-oesophageal reflux disease questionnaire score and reported side effects.

RESULTS:

One hundred and eleven patients in the gabapentin group and 106 in the baclofen group completed the study. The overall success rate for cough resolution was comparable (57.3% vs 53.0%, χ2  = 0.357, P = 0.550) between the two groups. In parallel, cough sensitivity to capsaicin and gastro-oesophageal reflux disease questionnaire score decreased after treatment with either gabapentin or baclofen. However, gabapentin was associated with less frequent somnolence (20.5% vs 35.0%, χ2  = 6.156, P = 0.013) and dizziness (11.1% vs 23.9%, χ2  = 6.654, P = 0.010) than baclofen.

CONCLUSIONS:

Gabapentin and baclofen have similar therapeutic efficacy for suspected refractory gastro-oesophageal reflux-induced chronic cough. However, gabapentin may be preferable because of fewer side effects. Trial Register: http://www.chictr.org/; No.: ChiCTR-ONC-13003066.

• Authors: Ran Dong, Xianghuai Xu, Li Yu, Hongmei Ding, Jing Pan, Yiming Yu, Cuiqin Shi, Qiang Chen, Mengru Zhang, Hanjing Lv, Zhongmin Qiu
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 49 Issue 6 Pg. 714-722 (03 2019) ISSN: 1365-2036 [Electronic] England
• PMID: 30740748 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 John Wiley & Sons Ltd.

Chemical References

• Analgesics
• Muscle Relaxants, Central
• Gabapentin
• Baclofen

Topics

• Adult
• Analgesics (therapeutic use)
• Baclofen (therapeutic use)
• Chronic Disease
• Cough (complications, diagnosis, drug therapy)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Gabapentin (therapeutic use)
• Gastroesophageal Reflux (diagnosis, drug therapy, etiology)
• Humans
• Male
• Middle Aged
• Muscle Relaxants, Central (therapeutic use)
• Treatment Outcome