Internal Medicine

Efficacy, adverse effects of gefapixant are dose-dependent in chronic cough treatment

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Gefapixant, a potential treatment for chronic cough in adults, appears to have dose-dependent efficacy and adverse effects, according to a recent meta-analysis.

The researchers conducted a comprehensive literature search of studies published on gefapixant up until September 2022. A subgroup analysis was performed based on the dose of gefapixant administered, categorizing the doses as low (≤20 mg twice daily), moderate (45-50 mg twice daily), and high (≥100 mg twice daily).

The analysis included 5 studies comprising 7 trials. The results demonstrated that moderate- or high-dose gefapixant was effective in reducing both objective 24-hour cough frequency and awake cough frequency, with estimated relative reductions of 30.9% and 58.5%, respectively (primary outcome). Furthermore, high-dose gefapixant also significantly reduced night-time cough frequency. The use of moderate- or high-dose gefapixant consistently improved cough severity and enhanced cough-related quality of life.

However, an increased risk of adverse events (AEs) associated with gefapixant treatment was noted. These included all-cause AEs, treatment-related AEs, and ageusia/dysgeusia/hypogeusia (impaired taste).

The efficacy and adverse effects of gefapixant were dose-dependent, with a cutoff dose identified as ≥45 mg twice daily.

Chuang MH, Chen IW, Chen JY, et al. Efficacy and safety of gefapixant for chronic cough: a meta-analysis of randomised controlled trials. Eur Respir Rev. 2023;32(168):220219. doi: 10.1183/16000617.0219-2022. PMID: 37197770.