Effectiveness of proton pump inhibitor in unexplained chronic cough

Hye Jung Park, Yoo Mi Park, Jie Hyun Kim, Hye Sun Lee, Hyung Jung Kim, Chul Min Ahn, Min Kwang Byun

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Current guidelines recommend that patients with unexplained chronic cough undergo empirical proton pump inhibitor (PPI) treatment, but scientific evidence for this treatment is lacking. We investigated the effectiveness and appropriate dose of PPI therapy in chronic cough. Methods: We included 27 patients with unexplained chronic cough after excluding subjects with positive response to postnasal drip medication. Subjects were randomized to a placebo, standard, and high dose of PPI groups with blinding. The drug or placebo was administered orally for 8 weeks, and the Leicester Cough Questionnaire (LCQ) score and visual analogue scale (VAS) scores were collected. Results: The LCQ score in the PPI group significantly improved from 0 weeks (11.4 ± 1.4) to 4 weeks (14.8 ± 1.4) and to 8 weeks (17.1 ± 1.4), whereas that in the placebo group did not improve from 0 weeks (13.7 ± 1.1) to 8 weeks (11.8 ± 1.4); the difference between the 2 groups was significant (P < 0.001). In subgroup analysis according to reflux, significant improvements in the LCQ score were observed in the PPI group regardless of reflux (P < 0.001 in the reflux group and P < 0.001 in the no reflux group, respectively; P = 0.188 between the 2 groups). In addition, improvements in LCQ and VAS scores between the standard- and high-dose PPI groups were not significantly different; however, adverse reactions were induced by only the high dose (16.7%). Conclusions: The results of this pilot study support the empirical use of the standard dose of PPI for 8 weeks in patients suffering from unexplained chronic cough regardless of whether reflux is present.

Original languageEnglish
Article numbere0185397
JournalPloS one
Volume12
Issue number10
DOIs
Publication statusPublished - 2017 Oct

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cough
Proton Pump Inhibitors
Cough
questionnaires
placebos
dosage
Placebos
Visual Analog Scale
proton pump inhibitors
drug therapy
Therapeutics
Guidelines
drugs
therapeutics
Surveys and Questionnaires
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Park, H. J., Park, Y. M., Kim, J. H., Lee, H. S., Kim, H. J., Ahn, C. M., & Byun, M. K. (2017). Effectiveness of proton pump inhibitor in unexplained chronic cough. PloS one, 12(10), [e0185397]. https://doi.org/10.1371/journal.pone.0185397
Park, Hye Jung ; Park, Yoo Mi ; Kim, Jie Hyun ; Lee, Hye Sun ; Kim, Hyung Jung ; Ahn, Chul Min ; Byun, Min Kwang. / Effectiveness of proton pump inhibitor in unexplained chronic cough. In: PloS one. 2017 ; Vol. 12, No. 10.
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title = "Effectiveness of proton pump inhibitor in unexplained chronic cough",
abstract = "Background: Current guidelines recommend that patients with unexplained chronic cough undergo empirical proton pump inhibitor (PPI) treatment, but scientific evidence for this treatment is lacking. We investigated the effectiveness and appropriate dose of PPI therapy in chronic cough. Methods: We included 27 patients with unexplained chronic cough after excluding subjects with positive response to postnasal drip medication. Subjects were randomized to a placebo, standard, and high dose of PPI groups with blinding. The drug or placebo was administered orally for 8 weeks, and the Leicester Cough Questionnaire (LCQ) score and visual analogue scale (VAS) scores were collected. Results: The LCQ score in the PPI group significantly improved from 0 weeks (11.4 ± 1.4) to 4 weeks (14.8 ± 1.4) and to 8 weeks (17.1 ± 1.4), whereas that in the placebo group did not improve from 0 weeks (13.7 ± 1.1) to 8 weeks (11.8 ± 1.4); the difference between the 2 groups was significant (P < 0.001). In subgroup analysis according to reflux, significant improvements in the LCQ score were observed in the PPI group regardless of reflux (P < 0.001 in the reflux group and P < 0.001 in the no reflux group, respectively; P = 0.188 between the 2 groups). In addition, improvements in LCQ and VAS scores between the standard- and high-dose PPI groups were not significantly different; however, adverse reactions were induced by only the high dose (16.7{\%}). Conclusions: The results of this pilot study support the empirical use of the standard dose of PPI for 8 weeks in patients suffering from unexplained chronic cough regardless of whether reflux is present.",
author = "Park, {Hye Jung} and Park, {Yoo Mi} and Kim, {Jie Hyun} and Lee, {Hye Sun} and Kim, {Hyung Jung} and Ahn, {Chul Min} and Byun, {Min Kwang}",
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Park, HJ, Park, YM, Kim, JH, Lee, HS, Kim, HJ, Ahn, CM & Byun, MK 2017, 'Effectiveness of proton pump inhibitor in unexplained chronic cough', PloS one, vol. 12, no. 10, e0185397. https://doi.org/10.1371/journal.pone.0185397

Effectiveness of proton pump inhibitor in unexplained chronic cough. / Park, Hye Jung; Park, Yoo Mi; Kim, Jie Hyun; Lee, Hye Sun; Kim, Hyung Jung; Ahn, Chul Min; Byun, Min Kwang.

In: PloS one, Vol. 12, No. 10, e0185397, 10.2017.

Research output: Contribution to journalArticle

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AU - Park, Hye Jung

AU - Park, Yoo Mi

AU - Kim, Jie Hyun

AU - Lee, Hye Sun

AU - Kim, Hyung Jung

AU - Ahn, Chul Min

AU - Byun, Min Kwang

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N2 - Background: Current guidelines recommend that patients with unexplained chronic cough undergo empirical proton pump inhibitor (PPI) treatment, but scientific evidence for this treatment is lacking. We investigated the effectiveness and appropriate dose of PPI therapy in chronic cough. Methods: We included 27 patients with unexplained chronic cough after excluding subjects with positive response to postnasal drip medication. Subjects were randomized to a placebo, standard, and high dose of PPI groups with blinding. The drug or placebo was administered orally for 8 weeks, and the Leicester Cough Questionnaire (LCQ) score and visual analogue scale (VAS) scores were collected. Results: The LCQ score in the PPI group significantly improved from 0 weeks (11.4 ± 1.4) to 4 weeks (14.8 ± 1.4) and to 8 weeks (17.1 ± 1.4), whereas that in the placebo group did not improve from 0 weeks (13.7 ± 1.1) to 8 weeks (11.8 ± 1.4); the difference between the 2 groups was significant (P < 0.001). In subgroup analysis according to reflux, significant improvements in the LCQ score were observed in the PPI group regardless of reflux (P < 0.001 in the reflux group and P < 0.001 in the no reflux group, respectively; P = 0.188 between the 2 groups). In addition, improvements in LCQ and VAS scores between the standard- and high-dose PPI groups were not significantly different; however, adverse reactions were induced by only the high dose (16.7%). Conclusions: The results of this pilot study support the empirical use of the standard dose of PPI for 8 weeks in patients suffering from unexplained chronic cough regardless of whether reflux is present.

AB - Background: Current guidelines recommend that patients with unexplained chronic cough undergo empirical proton pump inhibitor (PPI) treatment, but scientific evidence for this treatment is lacking. We investigated the effectiveness and appropriate dose of PPI therapy in chronic cough. Methods: We included 27 patients with unexplained chronic cough after excluding subjects with positive response to postnasal drip medication. Subjects were randomized to a placebo, standard, and high dose of PPI groups with blinding. The drug or placebo was administered orally for 8 weeks, and the Leicester Cough Questionnaire (LCQ) score and visual analogue scale (VAS) scores were collected. Results: The LCQ score in the PPI group significantly improved from 0 weeks (11.4 ± 1.4) to 4 weeks (14.8 ± 1.4) and to 8 weeks (17.1 ± 1.4), whereas that in the placebo group did not improve from 0 weeks (13.7 ± 1.1) to 8 weeks (11.8 ± 1.4); the difference between the 2 groups was significant (P < 0.001). In subgroup analysis according to reflux, significant improvements in the LCQ score were observed in the PPI group regardless of reflux (P < 0.001 in the reflux group and P < 0.001 in the no reflux group, respectively; P = 0.188 between the 2 groups). In addition, improvements in LCQ and VAS scores between the standard- and high-dose PPI groups were not significantly different; however, adverse reactions were induced by only the high dose (16.7%). Conclusions: The results of this pilot study support the empirical use of the standard dose of PPI for 8 weeks in patients suffering from unexplained chronic cough regardless of whether reflux is present.

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