Environmental and occupational respiratory disordersEffect of codeine on objective measurement of cough in chronic obstructive pulmonary disease
Section snippets
Subjects
Patients with stable COPD (FEV1 30-75% predicted) who complained of cough (subjective cough score of 2 or more; Table I) were invited for screening. Patients with exacerbations in the last month, previous acute hypercapnic ventilatory failure, or low transcutaneous oxygen saturation (<92%) were excluded. Current smokers and patients who reported a history of gastroesophageal reflux disease, postnasal drip, and asthma were ineligible. The study was approved by the Local Research Ethics
Results
Twenty-six patients were screened, 21 patients met the inclusion criteria and were enrolled in the randomized study, and 19 patients completed the study. Fourteen were male subjects, and subjects had a mean age of 68.0 ± 6.86 years (Table II). One patient did not complete both treatment days because of an episode of gastroenteritis, and 1 patient had an exacerbation related to paint fumes and was excluded. Complete data on 19 subjects are presented (Table III) and were analyzed. Two subjects
Discussion
This is the first double-blind, randomized, placebo-controlled study to use a range of outcomes, including ambulatory cough monitoring, to assess the efficacy of an antitussive agent in COPD. It shows that codeine has no additional antitussive effect above that of placebo in patients with stable COPD who complained of cough. However, both codeine and placebo showed substantial reductions in time spent coughing during the day compared with baseline, underlining the necessity for appropriately
References (31)
- et al.
Evaluation of a cough-specific quality-of-life questionnaire
Chest
(2002) The powerful placebo in cough studies?
Pulm Pharmacol Ther
(2002)- et al.
Application and validation of a computerized cough acquisition system for objective monitoring of acute cough: a meta-analysis
Chest
(2001) - et al.
Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey
Eur Respir J
(2002) - et al.
Development of a symptom specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ)
Thorax
(2003) - et al.
A cross-sectional comparison of two cough specific health related quality of life questionnaires
Thorax
(2003) - et al.
Capsaicin responsiveness and cough in asthma and chronic obstructive pulmonary disease
Thorax
(2000) - et al.
Measurements of cough in chronic obstructive pulmonary disease
Thorax
(2003) - et al.
Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough
J Int Med Res
(1983) - et al.
Dose response to codeine in patients with chronic cough
Clin Pharmacol Ther
(1971)
Objective assessment of cough suppressants under clinical conditions using a tape recorder system
Thorax
Objective assessment of antitussive agents in patients with chronic cough
J New Drugs
Dextromethorphan and codeine: comparison of plasma kinetics and antitussive effects
Eur J Respir Dis
An electromyographic method of objectively assessing cough intensity and use of the method to assess effects of codeine on the dose-response curve to citric acid
Br J Clin Pharmacol
Cough threshold after upper abdominal surgery
Thorax
Cited by (133)
Management of chronic refractory cough in adults
2020, European Journal of Internal MedicineA systematic review of methods of citric acid cough reflex testing
2019, Pulmonary Pharmacology and TherapeuticsCough in chronic lung disease: a state of the art review
2023, Journal of Thoracic Disease
Supported by an educational grant from GlaxoSmithKline Ltd.
Disclosure of potential conflict of interest: The authors have declared they have no conflict of interest.