Real-world usage and response to gefapixant in refractory chronic cough

Hisako Matsumoto¹, Yoshihiro Kanemitsu², Motoki Ohe³, Hiroshi Tanaka⁴, Kunihiko Terada⁵, Koichi Nishi⁶, Ryo Atsuta⁷, Johsuke Hara⁸, Junpei Saito⁹, Mitsuhide Ohmichi¹⁰, Tamotsu Ishizuka¹¹, Teruaki Nishiuma¹², Hideki Inoue¹³, Naoto Watanabe^{14

15}, Tatsuya Nagano¹⁶, Tetsuya Ueda¹⁷, Haruhiko Ogawa¹⁸, Shigeru Endo¹⁹, Takeshi Suzuki²⁰, Toshiyuki Kita²¹, Katsuya Fujimori²², Yoshihisa Ishiura²³, Masaki Fujimura^{24

25}, Akio Niimi²

Affiliations

¹ Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osaka, Japan.
² Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
³ Department of Respiratory Medicine, Motoki Clinic, Kanagawa, Japan.
⁴ Sapporo Cough Asthma and Allergy Center, Sapporo, Japan.
⁵ Terada Clinic, Respiratory Medicine and General Practice, Himeji, Japan.
⁶ Department of Respiratory Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
⁷ Department of Respiratory Medicine, Akihabara Atsuta Clinic, Tokyo, Japan.
⁸ Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.
⁹ Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
¹⁰ Ohmichi Clinic of Internal and Respiratory Medicine, Sapporo, Japan.
¹¹ Department of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
¹² Department of Respiratory Medicine, Kakogawa Central City Hospital, Hyogo, Japan.
¹³ Department of Respiratory Medicine, Asthma and Lung Clinic Tokyo, Tokyo, Japan.
¹⁴ Department of Allergy Internal Medicine, Seirei Yokohama Hospital, Kanagawa, Japan.
¹⁵ Tokyo Allergy and Respiratory Disease Research Institute, Tokyo, Japan.
¹⁶ Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
¹⁷ Department of Respiratory Medicine, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
¹⁸ Department of Respiratory Medicine, Kanazawa Kasuga Clinic, Kanazawa, Japan.
¹⁹ Department of Respiratory Medicine, Endo Clinic of Internal Medicine, Shizuoka, Japan.
²⁰ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
²¹ Department of Respiratory Medicine, NHO Kanazawa Medical Centre, Kanazawa, Japan.
²² Department of Internal Medicine, Agano City Hospital, Niigata, Japan.
²³ First Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
²⁴ Department of Respiratory Medicine, National Hospital Organization Nanao Hospital, Ishikawa, Japan.
²⁵ Cough Clinic, Komatsu Sophia Hospital, Ishikawa, Japan.

PMID: 40630384
PMCID: PMC12230748
DOI: 10.1183/23120541.01037-2024

Real-world usage and response to gefapixant in refractory chronic cough

Hisako Matsumoto et al. ERJ Open Res. 2025.

. 2025 Jul 7;11(4):01037-2024.

doi: 10.1183/23120541.01037-2024. eCollection 2025 Jul.

Authors

Affiliations

¹ Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osaka, Japan.
² Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
³ Department of Respiratory Medicine, Motoki Clinic, Kanagawa, Japan.
⁴ Sapporo Cough Asthma and Allergy Center, Sapporo, Japan.
⁵ Terada Clinic, Respiratory Medicine and General Practice, Himeji, Japan.
⁶ Department of Respiratory Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
⁷ Department of Respiratory Medicine, Akihabara Atsuta Clinic, Tokyo, Japan.
⁸ Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.
⁹ Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
¹⁰ Ohmichi Clinic of Internal and Respiratory Medicine, Sapporo, Japan.
¹¹ Department of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
¹² Department of Respiratory Medicine, Kakogawa Central City Hospital, Hyogo, Japan.
¹³ Department of Respiratory Medicine, Asthma and Lung Clinic Tokyo, Tokyo, Japan.
¹⁴ Department of Allergy Internal Medicine, Seirei Yokohama Hospital, Kanagawa, Japan.
¹⁵ Tokyo Allergy and Respiratory Disease Research Institute, Tokyo, Japan.
¹⁶ Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
¹⁷ Department of Respiratory Medicine, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
¹⁸ Department of Respiratory Medicine, Kanazawa Kasuga Clinic, Kanazawa, Japan.
¹⁹ Department of Respiratory Medicine, Endo Clinic of Internal Medicine, Shizuoka, Japan.
²⁰ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
²¹ Department of Respiratory Medicine, NHO Kanazawa Medical Centre, Kanazawa, Japan.
²² Department of Internal Medicine, Agano City Hospital, Niigata, Japan.
²³ First Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
²⁴ Department of Respiratory Medicine, National Hospital Organization Nanao Hospital, Ishikawa, Japan.
²⁵ Cough Clinic, Komatsu Sophia Hospital, Ishikawa, Japan.

PMID: 40630384
PMCID: PMC12230748
DOI: 10.1183/23120541.01037-2024

Abstract

Background: The real-world efficacy of the P2X3 antagonist gefapixant, a new class of antitussive for refractory chronic cough, is not yet fully understood. This study aimed to evaluate the real-world usage and response to gefapixant in patients with refractory chronic cough.

Methods: This multicentre retrospective study involved patients with refractory chronic cough who visited cough clinics and were prescribed gefapixant. Data collected included baseline demographics, cough characteristics, response to gefapixant, degree of taste disturbance (both assessed by cough specialists), and the course of cough after discontinuation, if applicable.

Results: 272 cases were analysed. The population was predominantly middle-aged females, with most patients having asthmatic cough as a comorbidity, dry cough, and predominantly daytime cough. Half of the patients reported a response rate of ≥5 on a 0-10 scale, with 25% reporting a response rate of ≥8. Among responders (response rate ≥5), improvement was largely seen within 2 weeks. The median treatment duration with gefapixant was 32 days (interquartile range 14-175 days), with longer treatment periods observed in responders. Responders typically had more severe pre-treatment cough, dry cough, asthmatic cough as a comorbidity and specific laryngeal sensations. In patients who discontinued gefapixant, sustained improvement was observed in responders. Taste disturbance was not associated with response to gefapixant and was less frequent in patients with cough triggers such as smoke, dry air, or scents, than in those without these triggers.

Conclusions: Gefapixant demonstrated a rapid and effective antitussive effect in this multicentre, real-world study.

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Conflict of interest statement

Conflict of interest: H. Matsumoto reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. Y. Kanemitsu reports grants from MSD, MSD life foundation; payment or honoraria for lectures, presentations, manuscript writing or educational events from GSK, Novartis Pharma, AstraZeneca, Sanofi, Kyorin and Zeria; and support for attending meetings from GSK and Sanofi. H. Tanaka reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. K. Terada reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. J. Saito reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin; support for attending meetings from Kyorin. M. Ohmichi reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. H. Inoue reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. T. Nagano reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. S. Endo reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. Y. Ishiura reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin. A. Niimi reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Kyorin, AstraZeneca, Sanofi, GSK and Novartis. The remaining authors have nothing to disclose.

Figures

**FIGURE 1**
a) Baseline cough severity based on response levels, where 0 indicates no cough and 10 indicates the most severe cough before gefapixant treatment; b) change in cough severity with gefapixant: cough severity measured at a median (interquartile range) 209 (29–391) days after gefapixant discontinuation, subtracted from baseline cough severity. Box-and-whisker plots show the upper, lower and median quartiles.

**FIGURE 2**
Total of the three laryngeal sensations (irritation, tickle and secretion in the throat) across nonresponders, mild, moderate and super-responders.

**FIGURE 3**
Total of the three cough triggers (smoke, dry air and scents) among patients with non-to-mild, moderate and severe taste disturbance.

See this image and copyright information in PMC

References

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Real-world usage and response to gefapixant in refractory chronic cough

Affiliations

Real-world usage and response to gefapixant in refractory chronic cough

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

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