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Updated: Jun 25, 2025

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Systematic review and meta-analysis: proton pump inhibitors slightly decrease the severity of chronic cough.

Diana-Elena Floria1,2,3, Mahmoud Obeidat1,4, Sarolta Beáta Kávási1,5

  • 1Centre for Translational Medicine, Semmelweis University, Üllői Út 26, Budapest, 1085, Hungary.

Scientific Reports
|May 25, 2024
PubMed
Summary
This summary is machine-generated.

Proton pump inhibitors (PPIs) mildly reduce the severity of chronic cough linked to acid reflux. This meta-analysis found PPIs offer a modest benefit, regardless of how long the treatment lasts.

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Area of Science:

  • Gastroenterology
  • Pulmonology
  • Pharmacology

Background:

  • Chronic cough is recognized as a potential extra-esophageal manifestation of gastroesophageal reflux disease (GERD).
  • Acid-suppressive medications, particularly proton pump inhibitors (PPIs), are frequently used to manage GERD-related symptoms, including chronic cough.
  • The efficacy of PPIs in treating non-specific chronic cough remains a subject of investigation.

Purpose of the Study:

  • To conduct a meta-analysis assessing the effects of acid-suppressive medications on adults experiencing non-specific chronic cough.
  • To evaluate the impact of PPIs compared to placebo in reducing cough severity and improving quality of life.
  • To investigate whether treatment duration influences the therapeutic response in GERD-associated chronic cough.

Main Methods:

  • Systematic search of three databases for placebo-controlled randomized trials (RCTs) published up to November 1, 2022.
  • Inclusion of 11 double-blinded, placebo-controlled RCTs evaluating PPIs for persistent cough.
  • Application of a random-effects model to calculate the standardized mean difference (SMD) with 95% confidence intervals (CI) for cough severity and quality of life.

Main Results:

  • Proton pump inhibitors demonstrated a statistically significant, albeit mild, decrease in cough severity compared to placebo (SMD 0.33; 95% CI 0.05; 0.61).
  • No significant difference in therapeutic response was observed between patients with non-specific chronic cough alone versus those with laryngopharyngeal reflux.
  • Prolonged treatment durations (4, 6, 8, and 12 weeks) did not yield significantly greater symptomatic improvement, with SMDs ranging from 0.31 to 0.34.
  • The pooled analysis indicated a non-significant improvement in quality of life with PPI use (SMD 0.39; 95% CI -0.51; 1.29).

Conclusions:

  • Proton pump inhibitors offer a mild benefit in reducing the severity of non-specific chronic cough.
  • The effectiveness of PPIs in managing this condition appears independent of the treatment duration.
  • Further research may be needed to fully elucidate the role of PPIs and optimize treatment strategies for GERD-related chronic cough.