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Gabapentin versus baclofen for treatment of refractory gastroesophageal reflux-induced chronic cough

Authors
  • Zhang, Mengru
  • Zhu, Yiqing
  • Dong, Ran
  • Qiu, Zhongmin
Type
Published Article
Journal
Journal of Thoracic Disease
Publisher
AME Publishing Company
Publication Date
Sep 01, 2020
Volume
12
Issue
9
Pages
5243–5250
Identifiers
DOI: 10.21037/jtd-2020-icc-002
PMID: 33145100
PMCID: PMC7578446
Source
PubMed Central
Keywords
Disciplines
  • Review Article on the 3rd International Cough Conference
License
Unknown

Abstract

Refractory gastroesophageal reflux-induced chronic cough (GERC) is a special type of gastroesophageal reflux disease (GERD) with predominant cough resistant to pragmatic standard anti-reflux therapy including antisecretory agents alone or in combination with promotility agents but with a favorable response to intensified anti-reflux treatment. The condition is not rare and is difficult to treat. Neuromodulators such as baclofen and gabapentin are considered potential therapeutic options for refractory GERC. Limited data indicate that gabapentin and baclofen could attenuate the cough symptom in patients with refractory GERC by blockade of gastroesophageal reflux or by direct antitussive effects. However, no study has compared the efficacy of these two drugs in treatment of refractory GERC. In an open-labeled randomized clinical study, we demonstrated that, as add-on therapy, gabapentin and baclofen had a similar prevalence of therapeutic success for suspected refractory GERC but gabapentin may be more preferable because of its fewer central side effects. The efficacy of baclofen and gabapentin was suboptimal, so further studies are needed to select the patients with refractory GERC suitable for precise treatment using these two neuromodulators.

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