Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
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Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 127-140

Safety and efficacy of gefapixant, a novel drug for the treatment of chronic cough: A systematic review and meta-analysis of randomized controlled trials

1 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
2 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
3 College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
4 Faculty of Medicine, Fayoum University, Fayoum, Egypt

Correspondence Address:
Dr. Ahmed Abu-Zaid
College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis 38163, Tennessee, USA

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/atm.ATM_417_20

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AIM: We conducted this systematic review and meta-analysis to investigate the efficacy and safety of gefapixant, a novel P2X3 receptor antagonist, in patients with chronic cough. METHODS: We searched four databases for randomized controlled trials (RCTs). We assessed the cough frequency, severity, total Leicester cough questionnaire (LCQ) score, and adverse events. We analyzed the data using Open Meta-Analyst and Review Manager Software. RESULTS: We included four unique studies (comprising five stand-alone RCTs) with 439 patients. Compared to placebo, gefapixant had positive anti-tussive effects by improving awake cough frequency (mean difference [MD] = −5.27, 95% confidence interval [CI] [−6.12, −4.42], P < 0.00001), night cough frequency (MD = −3.71, 95% CI [−6.57, −0.85], P = 0. 01), 24 h cough frequency (MD = −4.18, 95% CI [−5.01, −3.36], P < 0.00001), cough severity using the Visual Analog Scale (MD = −13.36, 95% CI [−17.80, −8.92], P < 0.00001), cough severity diary (MD = −0.88, 95% CI [−1.25, −0.51], P < 0.00001), and total LCQ score (MD = 2.00, 95% CI [1.15, 2.86], P = 0. 00001). Meta-regression analyses showed a positive correlation between the gefapixant dose and the incidence of any adverse event (relative risk [RR] = 0.239, 95% CI [0.093, 1.839], P = 0.001) and incidence of adverse event related to treatment (RR = 0.520, 95% CI [0.117, 0.922], P = 0.011). CONCLUSIONS: In patient with chronic cough, gefapixant exhibits favorable anti-tussive outcomes by improving the cough frequency, severity, and quality of life. While gefapixant is largely tolerable, its side effects (notably taste alteration) are dose dependent.

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