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Cough Update: Efficacy of antitussives treatments in patients with chronic cough

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eMediNexus    21 January 2021

The present analysis was to understand the comparative efficacy of treatments in patients with unexplained or refractory cough. Also it is important to increase the awareness related to proven treatments and their possible adverse effects in certain populations.

A literature search for studies that were published up to June 2012 were compared with symptomatic treatments for chronic cough. Two investigators had thoroughly screened each abstract along with the full-text articles. Meta-analysis with random-effects models were used to summarize treatment effects.

49 studies with 3,067 patients that included 68 therapeutic comparisons were identified. Opioids, along with certain nonopioids and non anesthetic antitussives had demonstrated efficacy for chronic cough in adults. When compared with placebo, effect sizes i.e. standardized mean differences for cough severity and cough frequency rate ratios) for opioids were 0.55 and 0.57, respectively. For dextromethorphan, effect sizes were 0.37 and 0.40, respectively. The total strength of evidence was limited due to inconsistency of results and by less numbers of direct comparisons. 

The meta-analysis concluded that even though the evidence is limited, opioid and certain nonopioid and nonanesthetic antitussives such as dextromethorphan demonstrated effectiveness for treating chronic cough in adults. 

Ref: Yancy WS Jr, McCrory DC, Coeytaux RR, et al. Efficacy and tolerability of treatments for chronic cough: a systematic review and meta-analysis. Chest. 2013 Dec;144(6):1827-1838.

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