Paper
Predictive value of clinical features for anti-reflux therapy response in suspected gastroesophageal reflux-induced chronic cough
Published Jan 1, 2023 · Tingting Xu, Wenzhi Zhan, Dongting Xu
Journal of Thoracic Disease
1
Citations
0
Influential Citations
Abstract
Background Not all gastroesophageal reflux-induced cough (GERC) patients respond to anti-reflux treatment. It is not certain whether reflux-related symptoms or other clinical characteristics could indicate a successful response to anti-reflux treatment. In this study, we aimed to investigate the relationship between clinical features and anti-reflux response. Methods We retrospectively analyzed the clinical characteristics of suspected GERC who had reflux-related symptoms or reflux evidence based on abnormal 24-hour esophageal pH value monitoring, or who had no evidence of other common causes of chronic cough in our chronic cough database with a standard case report form. All patients experienced anti-reflux treatment with proton pump inhibitors (PPIs) plus prokinetic agents for at least 2 weeks and were divided into responders and non-responders based on the treatment response. Results Among 241 patients with suspected GERC, 146 (60.6%) showed a successful response. There was no significant difference in regard to the proportion of reflux-related symptoms, and results of 24-hour esophageal pH value monitoring between responders and non-responders. Compared with non-responders, responders had higher proportions of nasal itching (21.2% vs. 8.4%; P=0.014), tickle in the throat (51.4% vs. 35.8%; P=0.025) and lower proportion of pharyngeal foreign body sensation (32.9% vs. 54.7%; P=0.001). Multivariate analysis showed that nasal itching [hazard ratio (HR): 1.593, 95% confidence interval (CI): 1.025–2.476, P=0.039], tickle in the throat (HR: 1.605, 95% CI: 1.152–2.238, P=0.005), pharyngeal foreign body sensation (HR: 0.499, 95% CI: 0.346–0.720, P<0.001) and sensitivity to at least one cough trigger (HR: 0.480, 95% CI: 0.237–0.973, P=0.042) were associated with the therapeutic response. Conclusions Over half of suspected GERC patients benefited from anti-reflux therapy. A few clinical features rather than reflux-related symptoms might indicate a response to anti-reflux treatment. Further study is needed for the predictive value.
Observational StudyOver half of suspected GERC patients benefit from anti-reflux therapy, with nasal itching, tickle in the throat, pharyngeal foreign body sensation, and sensitivity to at least one cough trigger being associated with treatment response.
Full text analysis coming soon...