Randomised clinical trial: high-dose acid suppression for chronic cough - a double-blind, placebo-controlled study.

Shaheen NJ, Crockett SD, Bright SD, Madanick RD, Buckmire R, Couch M, Dellon ES, Galanko JA, Sharpless G, Morgan DR, Spacek MB, Heidt-Davis P, Henke D
Aliment Pharmacol Ther. 2011 33 (2): 225-34

PMID: 21083673 · PMCID: PMC3073617 · DOI:10.1111/j.1365-2036.2010.04511.x

BACKGROUND - Cough may be a manifestation of gastro-oesophageal reflux disease (GERD). The utility of acid suppression in GERD-related cough is uncertain.

AIM - To assess the impact of high-dose acid suppression with proton pump inhibitors (PPI) on chronic cough in subjects with rare or no heartburn.

METHODS - Subjects were nonsmokers without history of asthma, with chronic cough for >8 weeks. All subjects underwent a baseline 24-h pH/impedance study, methacholine challenge test and laryngoscopy. Subjects were randomised to either 40 mg of esomeprazole twice daily or placebo for 12 weeks. The primary outcome measure was the Cough-Specific Quality of Life Questionnaire (CQLQ). Secondary outcomes were response on Fisman Cough Severity/Frequency scores and change in laryngeal findings.

RESULTS - Forty subjects were randomised (22 PPI, 18 placebo) and completed the study. There was no difference between PPI and placebo in CQLQ (mean improvement 9.8 vs. 5.9 respectively, P = 0.3), or Fisman Cough Severity/Frequency scores. Proportion of patients who improved by >1 s.d. on the CQLQ was 27.8% (five of 18) and 31.8% (seven of 22) in the placebo and PPI groups respectively.

CONCLUSION - In subjects with chronic cough and rare or no heartburn, high-dose proton pump inhibitor does not improve cough-related quality of life or symptoms.

© 2010 Blackwell Publishing Ltd.

MeSH Terms (17)

Adolescent Adult Aged Chronic Disease Cough Double-Blind Method Esomeprazole Female Gastroesophageal Reflux Humans Male Middle Aged Proton Pump Inhibitors Severity of Illness Index Statistics as Topic Treatment Outcome Young Adult

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