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Gabapentin for refractory chronic cough: a randomised, double-blind, placebo-controlled trial
Nicole M Ryan1, Surinder S Birring, Peter G Gibson
1Priority Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia. nicole.ryan@newcastle.edu.au
Lancet (London, England)
|September 7, 2012
Summary
Gabapentin effectively treats refractory chronic cough, significantly improving quality of life. This neuromodulator is well-tolerated, suggesting central sensitization plays a key role in this condition.
Area of Science:
- Pulmonology
- Neurology
- Clinical Pharmacology
Background:
- Refractory chronic cough significantly impairs quality of life.
- Central reflex sensitization may be a key mechanism, similar to neuropathic pain.
- Neuromodulators like gabapentin are potential treatments.
Purpose of the Study:
- To establish the efficacy and tolerability of gabapentin for refractory chronic cough.
- To investigate gabapentin's effect on cough-specific quality of life.
Main Methods:
- Randomized, double-blind, placebo-controlled trial.
- Adults with chronic cough (>8 weeks) received gabapentin (up to 1800 mg/day) or placebo for 10 weeks.
- Primary endpoint: change in Leicester Cough Questionnaire (LCQ) score at 8 weeks.
Main Results:
- Gabapentin significantly improved cough-specific quality of life compared to placebo (p=0.004).
- The number needed to treat was 3.58.
- Side effects (nausea, fatigue) were more common with gabapentin but generally mild.
Conclusions:
- Gabapentin is an effective and well-tolerated treatment for refractory chronic cough.
- Results support central reflex sensitization as a relevant mechanism.
- Gabapentin offers a new therapeutic option for this debilitating condition.
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