[Chronic Cough]

Here we summarize the most important new scientific developments in the field of chronic cough (CC). Many have been already considered in the new German Cough Guidelines published 2025. We explain the difference between chronic cough on the one hand as a symptom of almost all respiratory and other diseases and on the other, cough as a disease on its own right: refractory chronic cough and unexplained chronic cough (RCC/UCC). In the German version of ICD 10 a new code was introduced for these entities: U69.6. Every patient with CC should undergo a basic diagnostic procedure including history, physical exam, a chest X-ray and a lung function test. According to a detailed history checking for typical features of a symptomatic CC or RCC/UCC many patients may need further targeted, "personalized" often multidisciplinary diagnosis including all clinically suspected potential causes. We highlight the benefits and a range of possible practical applications of objective cough monitoring with special smartphone and "cough watch" software. We discuss peripheral and central neuronal hypersensitivity of the cough reflex and hence, the scientific base of RCC/UCC. This central neuronal hypersensitivity may also be responsible for a high placebo effect in CC drug trials. Thus, it may be difficult to prove the therapeutic effect of a new drug, i.e. Gefapixant, the first recently approved treatment for RCC/UCC. We discuss the different CC phenotypes and endotypes, they will require development of new differentiated therapies. Finally, we discuss some new pipeline drugs in development.