CHEST Guidelines-Treatment-of-Unexplained-Chronic-Cough

Treatment-of-Unexplained-Chronic-Cough_chest

Pdf Summary

The CHEST Guideline and Expert Panel Report on unexplained chronic cough (UCC) provides a systematic review of randomized controlled trials (RCTs) to evaluate the efficacy of treatments compared to usual care for the management of UCC. UCC is characterized as a persistent cough lasting more than eight weeks without an identifiable cause after comprehensive investigation and treatment trials. It significantly impacts the quality of life and requires effective management strategies.<br /><br />The report includes evaluations of 11 RCTs and five systematic reviews, highlighting various treatments for UCC. Among the findings, gabapentin showed positive effects on improving cough-related quality of life, warranting its recommendation for treating UCC. However, inhaled corticosteroids (ICS) were found ineffective unless there's positive testing for bronchial hyperresponsiveness or eosinophilic bronchitis. Esomeprazole was ineffective for UCC without gastroesophageal reflux disease symptoms, and no studies addressed non-acid reflux.<br /><br />Multimodality speech pathology therapy proved beneficial in reducing cough severity, suggesting its utility in UCC management. The guidelines propose these treatments based on current evidence but also urge further research to refine diagnosis criteria and therapeutic strategies.<br /><br />The panel underscores the need for adherence to best-practice guidelines during assessment and treatment trials for UCC, emphasizing consistency in terminology and methodologies to enhance the reliability of future research findings. The report also identifies significant gaps in current knowledge, suggesting avenues for future investigations including the potential role of novel therapeutics and more rigorous study designs to improve the understanding and management of UCC. <br /><br />These guidelines fill a crucial need for structured assessment processes and provide initial treatment recommendations while calling for more comprehensive studies to address existing limitations and refine therapeutic interventions.

Keywords

unexplained chronic cough

CHEST guideline

randomized controlled trials

gabapentin

inhaled corticosteroids

speech pathology therapy

quality of life

treatment strategies

research gaps

therapeutic interventions