Characterization of Codeine Treatment Responders Among Patients with Refractory or Unexplained Chronic Cough: A Prospective Real-World Cohort Study.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM
Lung Pub Date : 2024-04-01 Epub Date: 2024-02-27 DOI:10.1007/s00408-024-00674-6
Ji-Yoon Oh, Sung-Yoon Kang, Noeul Kang, Ha-Kyeong Won, Eun-Jung Jo, Seung-Eun Lee, Ji-Hyang Lee, Ji-Su Shim, Young-Chan Kim, Youngsang Yoo, Jin An, Hwa Young Lee, So-Young Park, Mi-Yeong Kim, Ji-Ho Lee, Byung-Keun Kim, Han-Ki Park, Min-Hye Kim, Sae-Hoon Kim, Sang-Heon Kim, Yoon-Seok Chang, Sang-Hoon Kim, Byung-Jae Lee, Kian Fan Chung, Sang-Heon Cho, Woo-Jung Song
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引用次数: 0

Abstract

Purpose: Codeine is a narcotic antitussive often considered for managing patients with refractory or unexplained chronic cough. This study aimed to evaluate the proportion and characteristics of patients who responded to codeine treatment in real-world practice.

Methods: Data from the Korean Chronic Cough Registry, a multicenter prospective cohort study, were analyzed. Physicians assessed the response to codeine based on the timing and degree of improvement after treatment initiation. Follow-up assessments included the Leicester Cough Questionnaire and cough severity visual analog scale at six months. In a subset of subjects, objective cough frequency was evaluated following the initiation of codeine treatment.

Results: Of 305 patients, 124 (40.7%) responded to treatments based on anatomic diagnostic protocols, while 181 (59.3%) remained unexplained or refractory to etiological treatments. Fifty-one subjects (16.7%) were classified as codeine treatment responders (those showing a rapid and clear response), 57 (18.7%) as partial responders, and 62 (20.3%) as non-responders. Codeine responders showed rapid improvement in objective cough frequency and severity scores within a week of the treatment. At 6 months, responders showed significantly improved scores in cough scores, compared to non-responders. Several baseline parameters were associated with a more favorable treatment response, including older age, non-productive cough, and the absence of heartburn.

Conclusions: Approximately 60% of chronic cough patients in specialist clinics may require antitussive drugs. While codeine benefits some, only a limited proportion (about 20%) of patients may experience rapid and significant improvement. This underscores the urgent need for new antitussive drugs to address these unmet clinical needs.

Abstract Image

难治性或不明原因慢性咳嗽患者中可待因治疗应答者的特征:一项前瞻性真实世界队列研究。
目的:可待因是一种麻醉性止咳药,常被考虑用于治疗难治性或原因不明的慢性咳嗽患者。本研究旨在评估现实世界中对可待因治疗有反应的患者比例和特征:分析了韩国慢性咳嗽登记处的数据,这是一项多中心前瞻性队列研究。医生根据开始治疗后的时间和改善程度来评估对可待因的反应。随访评估包括莱斯特咳嗽问卷和六个月的咳嗽严重程度视觉模拟量表。在一部分受试者中,可待因治疗开始后对客观咳嗽频率进行了评估:结果:在 305 名患者中,124 人(40.7%)对基于解剖诊断方案的治疗有反应,181 人(59.3%)仍无法解释病因或对病因治疗无效。51名受试者(16.7%)被归类为可待因治疗应答者(表现出快速而明确的应答),57名(18.7%)为部分应答者,62名(20.3%)为无应答者。可待因治疗应答者在治疗后一周内的客观咳嗽频率和严重程度评分均有迅速改善。6 个月后,与无应答者相比,有应答者的咳嗽评分明显改善。一些基线参数与更有利的治疗反应相关,包括年龄较大、无痰咳嗽和无胃灼热:结论:在专科门诊中,约有 60% 的慢性咳嗽患者可能需要服用止咳药。虽然可待因能使部分患者受益,但只有一小部分(约 20%)患者的病情能得到迅速而显著的改善。这说明迫切需要新的止咳药来满足这些尚未得到满足的临床需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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