Gabapentin is right choice for treatment of chronic cough due to GERD

China: Gabapentin (a pure neuromodulator) with baclofen are equally effective for the treatment of chronic cough induced by gastroesophageal reflux disease (GERD), however, gabapentin may be preferable due to fewer side effects.

These are the findings of a new study published in the journal Alimentary Pharmacology & Therapeutics.

Neuromodulators are considered as the potential options for the treatment of refractory gastro‐oesophageal reflux‐induced chronic cough. Zhongmin Qiu, Tongji University School of Medicine, Shanghai, China, and colleagues set out to compare the efficacy of gabapentin and baclofen in patients with suspected refractory gastro‐oesophageal reflux‐induced chronic cough.

GERD is one of the most common causes of chronic, unexplained cough. Despite the established association, and even in the face of a positive ambulatory pH test, the cough often does not respond to acid-suppressing therapy, and prokinetic agents and neuromodulators are often suggested as a next step.

This study compared gabapentin (a pure neuromodulator) with baclofen (a prokinetic with neuromodulator effect) in 217 patients with established GERD who had a cough that had not responded to an 8-week course of omeprazole (twice daily) and domperidone (10 mg 3 times daily).

Also Read: Updated CHEST Guideline for Chronic Cough due to GERD in Adults

Key Findings:

• There was no difference in cough resolution between the gabapentin and baclofen recipients — roughly 55% for each group.


• In parallel, cough sensitivity to capsaicin and gastro‐oesophageal reflux disease questionnaire score decreased after treatment with either gabapentin or baclofen.


• Gabapentin had fewer adverse effects (somnolence and dizziness were more common with baclofen).

Also Read: PPIs used alone not beneficial in Chronic Cough due to GERD: Expert Panel Report

The bottom line is -- The study has confirmed that as an add‐on therapy for the treatment of suspected refractory gastro‐oesophageal reflux‐induced chronic cough, gabapentin achieved similar therapeutic efficacy to baclofen but presented with fewer side effects, underpinned by a comparable decrease in cough symptom score, gastro‐oesophageal reflux disease questionnaire score and cough sensitivity.

For further reference follow the link: https://doi.org/10.1111/apt.15169