Titre du document / Document title

Effect of codeine on objective measurement of cough in chronic obstructive pulmonary disease

Auteur(s) / Author(s)

SMITH Jaclyn ⁽¹⁾ ; OWEN Emily ⁽¹⁾ ; EARIS John ⁽²⁾ ; WOODCOCK Ashley ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ North West Lung Centre, South Manchester University Hospitals Trust, Manchester, ROYAUME-UNI
⁽²⁾ Aintree Chest Centre, University Hospital Aintree, Liverpool, ROYAUME-UNI

Résumé / Abstract

Background: Codeine is the standard antitussive treatment to which novel agents are compared. Little is known about the objective effect of any treatments on cough in chronic obstructive pulmonary disease (COPD). Objective: To quantify the effect of codeine on objective cough frequency (quantified as time spent coughing: cough seconds, cs/h), citric acid cough threshold, and subjective measures in a double-blind, placebo-controlled crossover study in COPD. Methods: We studied 21 patients with physician-diagnosed, stable disease who complained of cough (76.9% male; mean age, 67.7 years; mean predicted FEV₁, 53.4%; median smoking history, 43.5 pack-years). Each subject performed a cough challenge (single breath, citric acid), 10-hour daytime ambulatory and overnight cough recordings, subjective cough scores, and visual analog scales at baseline and on 2 study days, 1 week apart. Codeine phosphate 60 mg or matched placebo were given, in random order, at the start of each cough recording (0 and 12 hours). Results: Median time spent coughing at baseline was 8.27 cs/h (interquartile range [IQR], 5.94-11.67); after placebo treatment, 7.22 cs/h (IQR 4.42-10.40); and after codeine treatment, 6.41 cs/h (IQR 3.86-9.10). Codeine treatment had a significant effect on time spent coughing compared with baseline (P = .02) but not compared with placebo (P = .52). There were no significant differences in cough challenge thresholds (log concentration of tussive agent causing 2 coughs or log concentration of tussive agent causing 5 coughs) or subjective cough measures for codeine compared with placebo. Conclusion: In this study, codeine was no more effective than placebo in patients with COPD complaining of cough. Clinical implications: Codeine is the antitussive agent to which we compare new treatments; however, in a group of stable patients with COPD, it had no effect on cough frequency over placebo.

Revue / Journal Title

Journal of allergy and clinical immunology   ISSN 0091-6749   CODEN JACIBY 

Source / Source

2006, vol. 117, n^o4, pp. 831-835 [5 page(s) (article)] (31 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1971) (Revue)

Mots-clés anglais / English Keywords

Lung disease ; Bronchus disease ; Respiratory disease ; Opiates ; Immunopathology ; Immunology ; Chronic disease ; Bronchitis ; Obstructive pulmonary disease ; Surveillance ; Cough ; Placebo ; Chronic ;

Mots-clés français / French Keywords

Poumon pathologie ; Bronche pathologie ; Appareil respiratoire pathologie ; Opiacés ; Immunopathologie ; Immunologie ; Maladie chronique ; Bronchite ; Bronchopneumopathie obstructive ; Surveillance ; Toux ; Placebo ; Chronique ; Codéine ;

Mots-clés espagnols / Spanish Keywords

Pulmón patología ; Bronquio patología ; Aparato respiratorio patología ; Opiados ; Inmunopatología ; Inmunología ; Bronquitis ; Broncopneumopatía obstructiva ; Vigilancia ; Tós ; Placebo ; Crónico ;

Mots-clés d'auteur / Author Keywords

Antitussives ; chronic bronchitis ; placebo ; chronic obstructive pulmonary disease ; cough ; cough monitoring ;

Localisation / Location

INIST-CNRS, Cote INIST : 2059, 35400015677124.0160