Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency

Background Treatment of chronic cough remains a challenge. We hypothesised that inhaled alkaline hypertonic divalent salts (alkaline HDS) might provide relief for refractory chronic cough by laryngeal and tracheal hydration. Methods We conducted an exploratory, single-blinded, nasal saline-controlle...

Full description

Saved in:
Bibliographic Details
Main Authors: Hisham Abubakar-Waziri, David A. Edwards, Deen Bhandu Bhatta, James H. Hull, Matthew Rudd, Peter Small, Kian Fan Chung
Format: Article
Language:English
Published: European Respiratory Society 2024-10-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/10/5/00241-2024.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846170548612104192
author Hisham Abubakar-Waziri
David A. Edwards
Deen Bhandu Bhatta
James H. Hull
Matthew Rudd
Peter Small
Kian Fan Chung
author_facet Hisham Abubakar-Waziri
David A. Edwards
Deen Bhandu Bhatta
James H. Hull
Matthew Rudd
Peter Small
Kian Fan Chung
author_sort Hisham Abubakar-Waziri
collection DOAJ
description Background Treatment of chronic cough remains a challenge. We hypothesised that inhaled alkaline hypertonic divalent salts (alkaline HDS) might provide relief for refractory chronic cough by laryngeal and tracheal hydration. Methods We conducted an exploratory, single-blinded, nasal saline-controlled study in 12 refractory chronic cough patients to examine cough suppression efficacy of an alkaline HDS composition (SC001) at pH 8 or pH 9 administered by nasal inhalation. As control, we used nasal saline with the same hand-held pump spray aerosol device. Each subject was monitored continuously using a digital cough monitor watch for 1 week of baseline, 1 week of control treatment and 1 week of active treatment. Results Baseline daily cough rates ranged from 4 to 34 coughs·h−1 with mean visual analogue score 65±17 pre- and post-baseline testing. Control-adjusted efficacy of cough rate reduction ranged from 15% (p=0.015) (from Day 1) to 23% (p=0.002) (from Day 3). Control-adjusted efficacy was highest with SC001 pH 9 (n=5), ranging from 25% (p=0.03) (from Day 1) to 35% (p=0.02) (from Day 3), and lowest for SC001 pH 8 (n=7), ranging from 9% (p=0.08) (from Day 1) to 16% (p=0.02) (from Day 3). Hourly cough counts and visual analogue score correlated for baseline (r=0.254, p=0.02) and control (r=0.299, p=0.007) monitoring weeks. Treatment improved this correlation (r=0.434, p=0.00006). No adverse events were reported. Conclusions Alkaline (pH 9) HDS aerosol is a promising treatment for refractory chronic cough and should be further evaluated.
format Article
id doaj-art-b7b50f86db8c4494b9289d2dc6fb5cf7
institution Kabale University
issn 2312-0541
language English
publishDate 2024-10-01
publisher European Respiratory Society
record_format Article
series ERJ Open Research
spelling doaj-art-b7b50f86db8c4494b9289d2dc6fb5cf72024-11-11T16:33:07ZengEuropean Respiratory SocietyERJ Open Research2312-05412024-10-0110510.1183/23120541.00241-202400241-2024Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequencyHisham Abubakar-Waziri0David A. Edwards1Deen Bhandu Bhatta2James H. Hull3Matthew Rudd4Peter Small5Kian Fan Chung6 National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield Hospital, London, UK Center for Nanomedicine, Johns Hopkins University Medical School, Baltimore, MD, USA Sensory Cloud Inc., Boston, MA, USA National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield Hospital, London, UK Hyfe Inc., Wilmington, DE, USA Hyfe Inc., Wilmington, DE, USA National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield Hospital, London, UK Background Treatment of chronic cough remains a challenge. We hypothesised that inhaled alkaline hypertonic divalent salts (alkaline HDS) might provide relief for refractory chronic cough by laryngeal and tracheal hydration. Methods We conducted an exploratory, single-blinded, nasal saline-controlled study in 12 refractory chronic cough patients to examine cough suppression efficacy of an alkaline HDS composition (SC001) at pH 8 or pH 9 administered by nasal inhalation. As control, we used nasal saline with the same hand-held pump spray aerosol device. Each subject was monitored continuously using a digital cough monitor watch for 1 week of baseline, 1 week of control treatment and 1 week of active treatment. Results Baseline daily cough rates ranged from 4 to 34 coughs·h−1 with mean visual analogue score 65±17 pre- and post-baseline testing. Control-adjusted efficacy of cough rate reduction ranged from 15% (p=0.015) (from Day 1) to 23% (p=0.002) (from Day 3). Control-adjusted efficacy was highest with SC001 pH 9 (n=5), ranging from 25% (p=0.03) (from Day 1) to 35% (p=0.02) (from Day 3), and lowest for SC001 pH 8 (n=7), ranging from 9% (p=0.08) (from Day 1) to 16% (p=0.02) (from Day 3). Hourly cough counts and visual analogue score correlated for baseline (r=0.254, p=0.02) and control (r=0.299, p=0.007) monitoring weeks. Treatment improved this correlation (r=0.434, p=0.00006). No adverse events were reported. Conclusions Alkaline (pH 9) HDS aerosol is a promising treatment for refractory chronic cough and should be further evaluated.http://openres.ersjournals.com/content/10/5/00241-2024.full
spellingShingle Hisham Abubakar-Waziri
David A. Edwards
Deen Bhandu Bhatta
James H. Hull
Matthew Rudd
Peter Small
Kian Fan Chung
Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
ERJ Open Research
title Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
title_full Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
title_fullStr Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
title_full_unstemmed Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
title_short Inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
title_sort inhaled alkaline hypertonic divalent salts reduce refractory chronic cough frequency
url http://openres.ersjournals.com/content/10/5/00241-2024.full
work_keys_str_mv AT hishamabubakarwaziri inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT davidaedwards inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT deenbhandubhatta inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT jameshhull inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT matthewrudd inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT petersmall inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency
AT kianfanchung inhaledalkalinehypertonicdivalentsaltsreducerefractorychroniccoughfrequency