RT Journal Article
SR Electronic
T1 A double-blind randomised placebo-controlled trial investigating the effects of lesogaberan on the objective cough frequency and capsaicin-evoked coughs in patients with refractory chronic cough
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00546-2021
DO 10.1183/23120541.00546-2021
VO 8
IS 1
A1 Huda Badri
A1 Carmen Gibbard
A1 Dimitra Denton
A1 Imran Satia
A1 Bashar Al-Sheklly
A1 Rachel J. Dockry
A1 Kimberley Holt
A1 Kevin McGuiness
A1 Sam Treadway
A1 Peter Whorwell
A1 Lesley Houghton
A1 Augustine Lee
A1 K. Jane Escott
A1 Theresa Lee
A1 Greame Wilkinson
A1 Alison Holt
A1 Brendan J. Canning
A1 Jacky A. Smith
YR 2022
UL http://openres.ersjournals.com/content/8/1/00546-2021.abstract
AB Objective Baclofen is a centrally acting γ-aminobutyric acid type B (GABAB) receptor agonist which reduces gastro-oesophageal reflux and suppresses the cough reflex; however, central nervous system side-effects limit its use. Lesogaberan is a novel peripherally acting GABAB agonist, but its effects on refractory chronic cough are unknown.Design We performed a single-centre, placebo-controlled, double-blind randomised crossover study in patients with chronic cough, refractory to the treatment of underlying conditions. Patients were randomised to treatment with lesogaberan 120 mg modified release twice daily or matched placebo for 2 weeks and then crossed over to the alternative therapy after a 2-week washout. The primary end-point was 24-h cough frequency measured with an acoustic monitoring system. In addition, cough responses to capsaicin were measured, and gastro-oesophageal reflux assessed by 24-h pH/impedance at screening.Results 22 patients were randomised to receive lesogaberan/placebo or placebo/lesogaberan (female (73%); mean±sd age 63.7±7.2 years; median (interquartile range) cough duration 10.5 (5.8–17.0) years; mean (95% CI) 45 (29–67) reflux events in 24 h; two patients had abnormal oesophageal acid exposure times). Although lesogaberan reduced cough counts by 26% over placebo, this did not reach statistical significance (p=0.12). However, lesogaberan did significantly improve cough responses to capsaicin (p=0.04) and the number of cough bouts (p=0.04) compared with placebo. Lesogaberan was well tolerated in this study.Conclusions Lesogaberan improved cough hypersensitivity and the number of bouts of coughing, but not coughs per hour. This implies a possible role for peripheral GABAB receptors in refractory chronic cough.Lesogaberan, a peripherally acting GABAB agonist, does not reduce 24-h cough frequency in patients with chronic cough despite significantly reducing capsaicin-induced coughing https://bit.ly/3uGyPQL