Abstract
BackgroundCough is one of the most common symptoms for which patients seek medical attention from primary care physicians and lung specialists. About 40% of the population at any one time report cough.Cough is associated with significantly impaired health-related quality of life.Levodropropizine is an effective and very well tolerated peripheral antitussive drug. We want to compare it to central cough suppressants efficacy (opioids and non-opioids) that may be associated with side effects limiting their use.MethodsAfter a comprehensive literature search, a meta-analysis of 7 clinical studies of levodropropizine vs. control, including a total of 1,178 patients, was performed with the aim to evaluate the overall comparative efficacy of levodropropizine in the pediatric and adult population.Three electronic databases and reference list were used to search for studies that assessed the efficacy of levodropropizine for treating cough in children and adults using as standardized efficacy parameters the cough frequency and severity, and number of night awakenings as outcome parameters.ResultsThe meta-analysis of all standardized efficacy parameters showed a highly statistically significant difference in the overall antitussive efficacy in favor of levodropropizine vs. control treatments (p = 0.0015).The heterogeneity test for the efficacy outcome was not statistically significant (p = 0.0534).Seven studies met out inclusion criteria. A meta-analysis of the eligible ones showed a statistically significant difference in the overall anti-tussive effect of levodropropizine versus control (p = 0.0015).ConclusionsThis analysis indicates that levodropropizine is an effective antitussive drug in children and adults, with statistically significant better overall efficacy outcomes vs. central antitussive drugs (codeine, cloperastine, dextromethorphan) in terms of reducing cough intensity and frequency, and nocturnal awakenings. This result further reinforces the favorable benefit/risk profile of levodropropizine in the management of cough. The efficacy of levodropropizine in the treatment of cough in children and adults is higher than that of the common centrally-acting anti-tussive.
Highlights
Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and lung specialists
The etiology of cough can be broadly classified into acute and chronic as deduced from the length of time it persists, acute cough lasting from 1 to 3 weeks and chronic cough lasting more than 8 weeks
Cough remains a serious unmet clinical problem [2]. It is a symptom of a range of diseases such as asthma, chronic obstructive pulmonary disease, gastro-esophageal reflux disease (GERD), or other conditions of unknown origin [2]
Summary
Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and lung specialists. About 40% of the population at any one time report cough. Cough is associated with significantly impaired health-related quality of life. We want to compare it to central cough suppressants efficacy (opioids and non-opioids) that may be associated with side effects limiting their use. Up to 40% of people at any one time report cough [2]. The etiology of cough can be broadly classified into acute and chronic as deduced from the length of time it persists, acute cough lasting from 1 to 3 weeks and chronic cough lasting more than 8 weeks. Regardless of whether it is acute or chronic, cough is associated with significantly impaired health-related quality of life, as sleep disturbance, nausea, chest pain and lethargy frequently occur [2].
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