American Cough Conference Preview: Diagnosing, Managing, and Treating Chronic Cough

Treating cough can be difficult. There are no FDA-approved therapies on the market in the United States, and companies with drugs in clinical trials have to contend with a large placebo effect.

Cough is a common issue for patients that can be divided into acute, subacute, and chronic cough depending on how long it lasts.

Treating cough can be tricky, because there is a large placebo effect. Cough, according to Ron Eccles, PhD, DSc, BSc, emeritus professor at Cardiff University, can be voluntarily controlled or inhibited.

During a session at the conference, Eccles will go into more detail on the placebo effect in cough and how to address it in clinical trials. He will speak during a session on general issues in cough clinical trials, such as the ideal trial design and developing a consumer technology–based automated cough counter.

The meeting will also cover 2 updates to cough guidelines:

  • 2020 European Respiratory Cough Management Guidelines
  • Pediatric updates in the CHEST cough guidelines

These updates will kick off the meeting with speakers who coauthored both guidelines.

Chronic cough, defined as a cough that lasts for 8 weeks or longer, is the key focus of the meeting. This type of cough may have underlying and treatable causes, explained Peter Dicpinigaitis, MD, chair of the American Cough Conference, professor of medicine at the Albert Einstein College of Medicine, director of the Montefiore Cough Center, and editor-in-chief of LUNG. However, there is a great need to treat chronic cough because there is “a significant subpopulation of patients who do not respond to treatment of these potential underlying causes.”

One of the causes of chronic cough could be asthma and asthma-like conditions, which will be addressed in a session on the mechanisms of cough. Other sessions will address diagnosing and managing the type or chronic cough that doesn’t respond to treatment and is ultimately diagnosed as refractory chronic cough.

Currently, there are no FDA-approved therapies for chronic cough on the market in the United States, and some sessions will address how patients are treated when there are no approved therapies. One speaker will highlight the role of a speech-language pathologist in the evaluation and management of chronic cough, while another will address what to do while waiting for the first drug approval.

The first half of day 2 of the meeting will be spent looking at the potential therapies that may come to market. First, experts will review the 4 P2X3 antagonists in clinical trial, and then the other therapies—neurokinin-1 receptor antagonists and voltage-gated sodium channel blockers—will be reviewed.

The 2-day meeting will close with oral abstracts covering a wide range of topics, including a mouse model, cough-related quality of life, and using artificial intelligence to monitor cough in real time.

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