Effect of tiotropium on cough reflex sensitivity in acute viral cough

Peter Vytautas Dicpinigaitis, Leah Spinner, Ganesha Santhyadka, Abdissa Negassa

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Study Objectives: Cough is the most common complaint for which patients in the United States seek medical attention. Few, if any, effective therapies exist for the most common form of acute cough, that due to viral upper respiratory tract infection (URI). The aim of this study was to evaluate the effect of the anticholinergic agent tiotropium bromide on cough reflex sensitivity in subjects with acute viral URI. Patients: Otherwise healthy adult nonsmokers with acute viral URI were randomized to receive inhaled tiotropium, 18 μg once daily, or matched placebo, for 7 days. A control group of healthy volunteers underwent an identical protocol. Measurements and Results: Cough reflex sensitivity to inhaled capsaicin was measured at baseline (Day 0), and 1 h after the first (Day 1) and seventh (Day 7) dose of tiotropium or placebo. Concentrations of capsaicin inducing two or more (C 2) and five or more coughs (C 5) were determined. In subjects with URI, tiotropium (n = 11) demonstrated inhibition of cough reflex sensitivity relative to baseline (increased log C 2 [p = 0.004] and log C 5 [p = 0.0004]) after the first dose. No change occurred in the placebo group (n = 10). After 7 days, mean log C 2 was significantly increased in the tiotropium group relative to placebo (p = 0.03). Although FEF25-75 was also increased in the tiotropium group (p = 0.016), there was no significant correlation between changes in cough reflex sensitivity and FEF25-75. Tiotropium had no effect in healthy volunteers (n = 24). Conclusions: Tiotropium inhibits cough reflex sensitivity to capsaicin in subjects with acute viral URI. The antitussive effect of tiotropium may occur through a mechanism other than bronchodilation.

Original languageEnglish (US)
Pages (from-to)369-374
Number of pages6
JournalLung
Volume186
Issue number6
DOIs
StatePublished - Dec 2008

Fingerprint

Cough
Reflex
Respiratory Tract Infections
Capsaicin
Placebos
Healthy Volunteers
Antitussive Agents
Tiotropium Bromide
Cholinergic Antagonists
Control Groups

Keywords

  • Anticholinergic
  • Capsaicin
  • Common cold
  • Cough
  • Tiotropium

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Effect of tiotropium on cough reflex sensitivity in acute viral cough. / Dicpinigaitis, Peter Vytautas; Spinner, Leah; Santhyadka, Ganesha; Negassa, Abdissa.

In: Lung, Vol. 186, No. 6, 12.2008, p. 369-374.

Research output: Contribution to journalArticle

Dicpinigaitis, Peter Vytautas ; Spinner, Leah ; Santhyadka, Ganesha ; Negassa, Abdissa. / Effect of tiotropium on cough reflex sensitivity in acute viral cough. In: Lung. 2008 ; Vol. 186, No. 6. pp. 369-374.
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abstract = "Study Objectives: Cough is the most common complaint for which patients in the United States seek medical attention. Few, if any, effective therapies exist for the most common form of acute cough, that due to viral upper respiratory tract infection (URI). The aim of this study was to evaluate the effect of the anticholinergic agent tiotropium bromide on cough reflex sensitivity in subjects with acute viral URI. Patients: Otherwise healthy adult nonsmokers with acute viral URI were randomized to receive inhaled tiotropium, 18 μg once daily, or matched placebo, for 7 days. A control group of healthy volunteers underwent an identical protocol. Measurements and Results: Cough reflex sensitivity to inhaled capsaicin was measured at baseline (Day 0), and 1 h after the first (Day 1) and seventh (Day 7) dose of tiotropium or placebo. Concentrations of capsaicin inducing two or more (C 2) and five or more coughs (C 5) were determined. In subjects with URI, tiotropium (n = 11) demonstrated inhibition of cough reflex sensitivity relative to baseline (increased log C 2 [p = 0.004] and log C 5 [p = 0.0004]) after the first dose. No change occurred in the placebo group (n = 10). After 7 days, mean log C 2 was significantly increased in the tiotropium group relative to placebo (p = 0.03). Although FEF25-75 was also increased in the tiotropium group (p = 0.016), there was no significant correlation between changes in cough reflex sensitivity and FEF25-75. Tiotropium had no effect in healthy volunteers (n = 24). Conclusions: Tiotropium inhibits cough reflex sensitivity to capsaicin in subjects with acute viral URI. The antitussive effect of tiotropium may occur through a mechanism other than bronchodilation.",
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