European Respiratory Society guideline adopting cough hypersensitivity syndrome as an overarching diagnosis for chronic cough. Recommends assessing cough impact (VAS, LCQ/CQLQ), treating treatable traits first (CVA/eosinophilic bronchitis with anti-inflammatory therapy; non-acid reflux with promotility agents), then neuromodulation: low-dose slow-release morphine 5-10 mg twice daily (strong recommendation, moderate-quality evidence), gabapentin, pregabalin plus speech pathology, and physiotherapy/speech-language therapy (cough control therapy) by experienced practitioners. Paediatric-specific algorithm advocated. Details

Lyfnua (gefapixant), a P2X3 receptor antagonist, is indicated for the treatment of refractory or unexplained chronic cough in adults. It was the first medicine authorised in the EU specifically for this condition. Details

Review framing chronic cough hypersensitivity as a neuropathic disorder characterized by heightened cough responses to stimuli affecting airways and vagally innervated tissues and excessive responses to innocuous stimuli, with implications for management and emerging treatments. Details

Lancet Respiratory Medicine 2020: pivotalle Phase-2b-RCT (NCT02612610, n=253) zu drei Gefapixant-Dosierungen vs. Placebo über 84 Tage. Nur 50 mg BID reduzierte die wache Hustenfrequenz signifikant um 37% relativ zu Placebo, ging jedoch mit Dysgeusie bei 48% der Patienten einher. Belegt Wirksamkeit des P2X3-Antagonismus sowie Geschmacksstörungen als zentrales Verträglichkeitsproblem. Details

Diese Phase-3b-RCT (90 Zentren, 12 Länder, n=375) prüfte Gefapixant 45 mg zweimal täglich über 12 Wochen bei Frauen mit refraktärem/unerklärtem chronischem Husten und husteninduzierter Belastungsinkontinenz. Tägliche CSUI-Episoden sanken um -52,8% (Gefapixant) vs. -41,1% (Placebo), Differenz -11,7% (p=0,004). Geschmacksbezogene AEs dominierten das Sicherheitsprofil (AE-Rate 70% vs. 37%). Details

European Respiratory Society guideline adopting cough hypersensitivity syndrome as an overarching diagnosis for chronic cough. Recommends assessing cough impact (VAS, LCQ/CQLQ), treating treatable traits first (CVA/eosinophilic bronchitis with anti-inflammatory therapy; non-acid reflux with promotility agents), then neuromodulation: low-dose slow-release morphine 5-10 mg twice daily (strong recommendation, moderate-quality evidence), gabapentin, pregabalin plus speech pathology, and physiotherapy/speech-language therapy (cough control therapy) by experienced practitioners. Paediatric-specific algorithm advocated. Details

Lyfnua (gefapixant), a P2X3 receptor antagonist, is indicated for the treatment of refractory or unexplained chronic cough in adults. It was the first medicine authorised in the EU specifically for this condition. Details

Review framing chronic cough hypersensitivity as a neuropathic disorder characterized by heightened cough responses to stimuli affecting airways and vagally innervated tissues and excessive responses to innocuous stimuli, with implications for management and emerging treatments. Details

Lancet Respiratory Medicine 2020: pivotalle Phase-2b-RCT (NCT02612610, n=253) zu drei Gefapixant-Dosierungen vs. Placebo über 84 Tage. Nur 50 mg BID reduzierte die wache Hustenfrequenz signifikant um 37% relativ zu Placebo, ging jedoch mit Dysgeusie bei 48% der Patienten einher. Belegt Wirksamkeit des P2X3-Antagonismus sowie Geschmacksstörungen als zentrales Verträglichkeitsproblem. Details

Diese Phase-3b-RCT (90 Zentren, 12 Länder, n=375) prüfte Gefapixant 45 mg zweimal täglich über 12 Wochen bei Frauen mit refraktärem/unerklärtem chronischem Husten und husteninduzierter Belastungsinkontinenz. Tägliche CSUI-Episoden sanken um -52,8% (Gefapixant) vs. -41,1% (Placebo), Differenz -11,7% (p=0,004). Geschmacksbezogene AEs dominierten das Sicherheitsprofil (AE-Rate 70% vs. 37%). Details