Chronic cough

Chronic cough: cough hypersensitivity and emerging treatments

Chronic cough is cough persisting for >8 weeks in adults^1–4. It impacts ~10% of adults in diverse general populations⁵. Chronic cough prevalence is higher in America, Europe, and Australia (10–20%) compared to Asia (<5%)⁵.

This condition is difficult to effectively treat because several pulmonary and extrapulmonary conditions can present with chronic cough^1–4.

Chronic cough can present without any verifiable cause or can be resistant to treatments that can improve diseases or conditions comorbid with cough^6,7.

Many patients with chronic cough have cough hypersensitivity, which is excessive coughing in response to non-noxious stimuli¹.

Cough hypersensitivity causes significant physical and psychiatric morbidity and adversely impacts quality of life^1,8.

New treatments for chronic cough in adults are under investigation following progress in explaining the mechanisms that contribute to cough hypersensitivity¹.

Chronic cough management is evolving towards a more patient-centric paradigm. This development is due to knowledge of differences in the pathology, involved organs, and patient factors, associated with chronic cough¹.

Advances in endotyping patients with chronic cough could help relieve the significant burden of this condition on patients and families^1–8.

References

1. Chung KF, McGarvey L, Song WJ, Chang AB, Lai K, Canning BJ, et al. Cough hypersensitivity and chronic cough. Nat Rev Dis Prim. 2022;30;8(1):45.
2. Morice AH, Millqvist E, Bieksiene K, Birring SS, Dicpinigaitis P, Ribas CD, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Euro Resp J. 2020 Jan 1;55(1).
3. Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS, Adams TM, Barker AF, Blackhall F, Bolser DC, Boulet LP. Treatment of unexplained chronic cough: CHEST guideline and expert panel report. Chest. 2016;149(1):27–
4. Kardos P, Dinh QT, Fuchs KH, Gillissen A, Klimek L, Koehler M, et al. German Respiratory Society guidelines for diagnosis and treatment of adults suffering from acute, subacute and chronic cough. Respir Med. 2020;170:105939.
5. Song WJ, Chang YS, Faruqi S, Kim JY, Kang MG, Kim S, et al. The global epidemiology of chronic cough in adults: a systematic review and meta-analysis. Euro Respir J. 2015;45(5):1479–
6. Dicpinigaitis PV. Chronic cough due to asthma: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1):75S–
7. Irwin RS. Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1):80S–
8. Meltzer EO, Zeiger RS, Dicpinigaitis P, Bernstein JA, Oppenheimer JJ, Way NA, et al. Prevalence and burden of chronic cough in the United States. J Allergy Clin Immunol: In Pract. 2021;9(11):4037–