Dataset Information

Prediction of therapeutic efficacy of gabapentin by Hull Airway Reflux Questionnaire in chronic refractory cough.

ABSTRACT:

Background

Gabapentin is recommended for the treatment of chronic refractory cough (CRC). This study aims to identify its therapeutic predictors in a prospective clinical study.

Methods

A total of 179 patients with CRC were treated with gabapentin. Prior to the therapy, all patients were assessed by Hull Airway Reflux Questionnaire (HARQ) and inhaled capsaicin challenge. When the treatment ended and cough resolution was confirmed, a stepwise logistic regression analysis was performed to identify the therapeutic predictors for gabapentin and to establish the prediction equation.

Results

Gabapentin treatment achieved a therapeutic success rate of 66.48%. HARQ scores were significantly higher in responders than non-responders to gabapentin (29.79?±?9.58 versus 21.95?±?7.83, t?=?-3.685, p?<0.001), which were positively related to the therapeutic efficacy of gabapentin (r?=?0.433, p?<0.001). The optimal cutoff point of 21.50 in HARQ presented with a moderate ability to predict gabapentin efficacy, with a sensitivity of 84.60% and specificity of 63.60%. Multiple logistic regression identified items of "A tickle in your throat, or a lump in your throat" (OR?=?7.927, p?=?0.005), "Cough when you get out of bed in the morning" (OR?=?7.016, p?=?0.045), and "Cough with eating" (OR?=?6.689, p?=?0.011) as independent predictors. The established logistic regression equation predicted 83.72% of the treatment success rate of gabapentin, which was verified by consequent preliminary revalidating study in 59 patients.

Conclusion

HARQ may be useful to screen patients with CRC most likely responsive to gabapentin, and help improve the therapeutic success.

Trial registration

http://www.chictr.org/; No.: ChiCTR-ONC-13003123.

SUBMITTER: Zhang M

PROVIDER: S-EPMC7768311 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Prediction of therapeutic efficacy of gabapentin by Hull Airway Reflux Questionnaire in chronic refractory cough.

Zhang Mengru M Chen Qiang Q Dong Ran R Yu Li L Ai Zisheng Z Xu Xianghuai X Qiu Zhongmin Z

Therapeutic advances in chronic disease 20201226

<h4>Background</h4>Gabapentin is recommended for the treatment of chronic refractory cough (CRC). This study aims to identify its therapeutic predictors in a prospective clinical study.<h4>Methods</h4>A total of 179 patients with CRC were treated with gabapentin. Prior to the therapy, all patients were assessed by Hull Airway Reflux Questionnaire (HARQ) and inhaled capsaicin challenge. When the treatment ended and cough resolution was confirmed, a stepwise logistic regression analysis was perfor ...[more]

PMID: 33489064

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Project description:Background and objectiveGastroesophageal reflux disease (GERD)-associated cough is defined as a special GERD with a predominant cough symptom and is a common cause of chronic cough. This review summarizes our current understanding on the pathogenesis and management of GERD-associated cough.MethodsMain literatures on the pathogenesis and management of GERD-associated cough were reviewed and our understandings derived from the published studies were showed then.Key content and findingsAlthough esophageal-tracheobronchial reflex mainly underlies the pathogenesis of GERD-associated cough, its counterpart-tracheobronchial-esophageal reflex might exist and initiate the cough due to reflux induced by upper respiratory tract infection through the signaling of transient receptor potential vanilloid 1 linking airway and esophagus. The presence of reflux-associated symptoms such as regurgitation and heartburn along with coughing suggests an association between cough and GERD, which is supported by the objective evidence of abnormal reflux as detected by reflux monitoring. Although there is no general consensus, esophageal reflux monitoring provides the main diagnostic criteria for GERD-associated cough. Despite that acid exposure time and symptom associated probability are useful and mostly employed reflux diagnostic criteria, they are imperfect and far from being the gold standard. Acid suppressive therapy has long been recommended as the first choice for GERD-associated cough. However, the overall benefits of proton pump inhibitors have been controversial and need to be further assessed, especially in patients with cough due to non-acid reflux. Neuromodulators have demonstrated potential therapeutic effects for refractory GERD-associated cough, for which anti-reflux surgery may also be a promising treatment option.ConclusionsTracheobronchial-esophageal reflex might initiate reflux-induced cough provoked by the upper respiratory tract infection. It is necessary to optimize the current standards and to explore new criteria with higher diagnostic potency. Acid suppressive therapy is the first choice for GERD-associated cough, followed by neuromodulators and anti-reflux surgery for refractory GERD-associated cough.

Dataset Information

Prediction of therapeutic efficacy of gabapentin by Hull Airway Reflux Questionnaire in chronic refractory cough.

Background

Methods

Results

Conclusion

Trial registration

Publications

Prediction of therapeutic efficacy of gabapentin by Hull Airway Reflux Questionnaire in chronic refractory cough.

Similar Datasets

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