The Current and Emerging Treatment Landscape forChronic CoughSep 13, 2022

Cough serves a protective physiologic function as a vital defensive reflex preventingaspiration. However, exposure to viral infections or other triggers induces, in someindividuals, a chronic cough (CC) that causes a significant symptomatic burden. Mostcases of CC are due to conditions that respond to appropriate therapeutic trials (upperairway cough syndrome; asthma; reflux). Unfortunately, a significant subgroup of patientswill have refractory CC, which does not respond to treatment of known underlying causesof CC. Currently, available therapeutic options for refractory CC are inadequate due tolimited efficacy and frequently intolerable adverse effects. Current professional societyguideline recommendations are discussed, and a promising pipeline of antitussive drugsin development is introduced, including purinergic 2X3 receptor antagonists, neurokinin-1 receptor antagonists, oral mixed κ-opioid receptor agonists/μ-opioid receptorantagonists, and voltage-gated sodium channel blockers.