PURPOSE:Chronic unexplained (“idiopathic”) cough (CUC) is a diagnosis of exclusion, when no cause can be determined, despite a thorough diagnostic work up. Management protocols for CUC have, historically, proven to be unsuccessful. We describe a combination product (Patent No. 11/820,545) that was successful in treating 8 patients diagnosed as having CUC.
METHODS:Eight subjects were enrolled in the study. All shared a common history of chronic coughwhereby, despite comprehensive medical evaluation, no cause could be determined and no treatment(s) found to be helpful. The study was preceded by an office visit to rule out any recent illness. All previous drugs known to alleviate cough were prohibited during the study. The combination product consisted of Dextromethorphan Hbr, 30 mg, Dexbrompheniramine maleate 6 mg, and Theobromine 500 mg. The product was given daily, as a B.I.D. dosing schedule, and was provided over a 3 week period. An office evaluation was performed at the end of each week. After 3 weeks, the medication was stopped. Follow up visits, however, continued one and two weeks after termination. Success in treatment was assessed subjectively by documenting a significant improvement in the Leicester QOL score. Objective evaluation was ascertained by documenting significant reductions in the frequency and severity of cough episodes.
RESULTS:Using the above criteria, all 8 subjects demonstrated improvement within the first week. By the end of the third week, patient CS experienced 100% improvement; patient RL –90% improvement; patient JB- 80% improvement; patient JB –70% improvement; patients KR, RF, MO –50% improvement; patient CS –20% improvement. Side effects included drowsiness in JB and RL, light headedness in RF, and insomnia in MO. All side effects, however, disappeared by the end of the third week. With the exception of CS, cough completely returned to pretreatment levels after drug termination.
CONCLUSION:We demonstrated that three medications, each working at different locations in the cough reflex loop, when used in combination can curtail CUC.
CLINICAL IMPLICATIONS:Treatment available for chronic unexplained cough.
DISCLOSURE:Brian Levine, No Financial Disclosure Information; No Product/Research Disclosure Information