Objective:

To evaluate the efficacy of an oral κ-opioid receptor agonist, nalbuphine, in reducing cough frequency in patients with idiopathic pulmonary fibrosis (IPF) and chronic cough.

Approach:

Key Findings:

• At 6 weeks, mean relative reductions in cough frequency were 48% (27 mg), 53% (54 mg), and 60% (108 mg) for nalbuphine, compared to 17% for placebo.
• Improvements in patient-reported cough frequency, severity, and quality of life were noted in the 54 mg and 108 mg groups.
• The 108 mg group showed a decline in absolute cough counts from 32 to 12 coughs per hour.

Interpretation:

Nalbuphine demonstrated a dose-dependent reduction in cough frequency and improvement in related symptoms among patients with IPF, suggesting potential as a treatment option.

Limitations:

• The treatment duration was limited to 6 weeks, restricting long-term efficacy and safety assessment.
• Findings require confirmation in larger phase 3 studies.
• Assumptions in the primary statistical analysis regarding missing data may introduce bias.

Conclusion:

Nalbuphine shows promise in reducing chronic cough in IPF patients, warranting further investigation in larger trials.

Sources:

• JAMA
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