Efficacy and tolerability of gefapixant for treatment of refractory or unexplained chronic cough: A Systematic Review and Dose-Response Meta-Analysis

Analysis (9 RCTs; n=2980) found gefapixant led to modest improvements in cough frequency (by 17.6%), cough severity (by 6.2 mm on 100-mm visual analog scale) & cough-specific quality of life (by 1 point on Leicester Cough Questionnaire; range, 3-21) but increased ADRs vs placebo.

SPS commentary:

Gefapixant is a P2X3 receptor antagonist that blocks the adenosine triphosphate–gated ion channel on chemically sensitive airway C-fibers, and is theorised to have the potential to decrease cough by reducing activation of airway C-fibers that transmit action potentials to the brain.

In July 2023, the European CHMP adopted a positive opinion recommending granting of marketing authorisation in EU for gefapixant tablets (Lyfnua) for treatment of refractory or unexplained chronic cough in adults .

A related editorial discusses the findings of the study and postulates potential reasons for the large placebo responses seen.

 

Journal of the American Medical Association

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Editorial