Chest
Original ResearchSigns and Symptoms of Chest DiseasesEfficacy and Tolerability of Treatments for Chronic Cough: A Systematic Review and Meta-analysis
Section snippets
Materials and Methods
This article summarizes a comparative effectiveness review commissioned by the Agency for Healthcare Research and Quality.14 Further details of the topic refinement, literature search, methods, and conclusions can be found in the full report.
Results
Figure 1 shows the flow of literature through the search and screening process. Forty-three articles describing 49 separate studies met the inclusion criteria (Table 1).15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57 One article15 reported results for six separate studies, whereas another37 described results for two separate studies. Only three studies39, 50, 56 were
Discussion
In studies that included an active or placebo comparison, we found evidence of relative efficacy for the reduction of frequency and severity of chronic cough only for codeine and dextromethorphan. Because of the small number of head-to-head comparisons and inconsistency and imprecision of results, however, we were unable to draw conclusions about the comparative effectiveness of these two agents. Tolerability concerns were found only for opioids.
The applicability of the findings to the United
Conclusions
A wide variety of pharmaceutical agents have been used to treat the symptom of chronic cough. However, there were relatively few good-quality studies that used reliable outcome measurements over pertinent durations of follow-up. The opioid and certain nonopioid and nonanesthetic antitussives most frequently demonstrated efficacy for managing the symptom of chronic cough, but there were insufficient data to draw conclusions about their relative efficacy. Data on nonpharmacologic therapies are
Acknowledgments
Author contributions: Dr Yancy had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Yancy: contributed to the study conception and design; data acquisition, analysis, and interpretation; drafting of the submitted manuscript; critical revision of the manuscript for important intellectual content; and final approval of the version to be published.
Dr McCrory: contributed to the study conception and design;
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Cited by (0)
Funding/Support: This project was funded by the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services [Contract 290-2007-10066-I]. Dr Goode is supported by the AHRQ K-12 Comparative Effectiveness Career Development Award [Grant HS19479-01].
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