Non-specific chronic cough, a persistent cough without a clear cause, affects approximately 9.6% of the global population and significantly impacts quality of life. Recognized by the Montreal consensus as an extra-esophageal manifestation of gastroesophageal reflux disease (GERD), it is also linked to asthma and post-nasal drip. Despite these associations, the efficacy of proton pump inhibitors (PPIs) for treating chronic cough remains controversial. A 2011 meta-analysis found insufficient evidence supporting PPIs for this condition.
Recent research, based on nine placebo-controlled randomized trials, found that PPIs slightly reduced cough severity. However, sensitivity analysis indicated that excluding a major study with a large sample size affected the statistical significance of the results. The study also showed similar effects of PPIs on cough severity in patients with both non-specific chronic cough and laryngopharyngeal reflux, with no significant reduction observed due to small sample sizes and wide confidence intervals. Improvement was more pronounced in patients with abnormal reflux on pH monitoring. Extended treatment durations did not enhance outcomes, and quality of life improvements were modest and not statistically significant. Mechanistic theories suggest that PPIs may not fully alleviate symptoms due to non-acidic reflux, and long-term PPI use has been linked to potential risks, including increased community-acquired pneumonia.
To Know More: https://doi.org/10.1038/s41598-024-62640-9
Reference: Floria DE, et al. Systematic review and meta-analysis: proton pump inhibitors slightly decrease the severity of chronic cough. Scientific Reports. 2024 May 25;14(1):11956.