Updates in treatment of adults with chronic cough

Abstract

Chronic cough is a severely debilitating condition that results in individuals coughing hundreds to thousands of times per day. Unfortunately, at the time of this writing, the majority of treatments currently available address acute cough and have minimal efficacy for chronic cough. There are no current FDA-approved pharmacologic treatments for chronic cough, resulting in a large, unmet need for patients. Recent advancements in the understanding of the chronic cough reflex and suspected neurobiology have led to the development of novel therapeutic targets to bridge this unmet treatment need. Current American College of Chest Physicians and European guidelines recommend a thorough workup but differ in individual pharmacologic treatment recommendations. All patients should be evaluated for red-flag symptoms and any underlying conditions that may explain the patient's chronic cough. Historical treatments, such as opiates and neuromodulators, have been used with limited success. Emerging agents that target specific channel receptors have shown initial positive benefits concerning cough frequency, severity, and quality of life and may become available on the market as they have shown to be generally well tolerated without any safety concerns in clinical studies.