SESSION TYPE: Pediatric Pulmonology Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Cough in children is the most common problems managed by pediatricians, and much attention has been drawn to the fact that commonly-used antitussive agents for the pediatric population are not supported by adequate efficacy data to justify their use. Mainly two classes of antitussives drugs are available: Centrally acting (opioids and non opioids) and peripherally acting levodropropizine, which is an orally-administered non-opiod agent whose peripheral antitussive actionmay result from its modulation of sensory neuropeptide levels within the respiratory tract.
METHODS: A comprehensive literature search was performed on the main electronic databases (PubMed/MEDLINE, EMBASE, and Cochrane Library) from their inception throughout January 2012, to identify original clinical studies of levodropropizine vs. control in the pediatric population. Overall, 4 studies including a total of 518 patients met the eligibility criteria. Three studies were conducted vs. central antitussives (Banderali 1995[ Kim Dong Soo 2002, and De Blasio 2012), and 1 study vs. placebo (Fiocchi 1991). We performed a meta-analysis with the aim to evaluate the overall efficacy of levodropropizine vs. control in children. In order to make the efficacy outcomes comparable, we standardized the variables of the different studies, in particular: cough severity, frequency of cough and nocturnal sleeping quality.Absol. Delta are the differences between the starting and ending values of parameters in levodropropizine and control treatment groups, DS are the (approx) standard deviations, and N are the numbers of cases studied.
RESULTS: The overall reduction of the severity of all efficacy parameters was higher in the levodropropizine group, and the difference vs. controls was highly statistically significant (P<0.01).
CONCLUSIONS: This analysis of these studies provides an overview of the major comparative evidence on levodropropizine in terms of efficacy in the pediatric setting. This standardized meta-analysis indicates that levodropropizine is an effective antitussive drug, showing better outcomes vs. central antitussives in terms of reducing cough intensity, frequency and nightly awakenings.
CLINICAL IMPLICATIONS: When children show cough symptom is very important first of all to identify the cause. When an antitussive treatment is required, a drug with solid clinical evidences should be used. Centrally acting cough suppressants, although largely used, have no consistent evidence of efficacy.
DISCLOSURE: Gianluca De Danieli: Employee: Medical Manager
Luigi Lanata: Employee: Mdical Director Dompè spa
The following authors have nothing to disclose: Francesco De Blasio, Alessandro Zanasi
No Product/Research Disclosure InformationRespiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Naple, Italy