Pregabalin Efficacy in Treatment of Chronic Neurogenic Cough

OBJECTIVES: Chronic neurogenic cough (CNC) is prevalent in Otolaryngology settings and impactful. Targeted neuromodulators may offer benefits. This longitudinal study of CNC patients taking pregabalin evaluates success of treatment, duration of treatment, and responses in relation to presence of other trigger conditions. METHODS: Ninety five patients (73% female, mean age 62y [12.5, SD]) treated with pregabalin for CNC were evaluated by patient-reported outcome measures, ratings of cough improvement and ability to discontinue therapy. RESULTS: Patients presented with mean 3.5 year [2.75 SD] cough duration. Seventy-eight percent of individuals administered pregabalin reported significant cough improvement or resolution, with mean 6.5 weeks [5, SD] of therapy. Significant reduction in HARQ from 32 [11, SD] to 22 [15, SD], [t-4.15, p = 0.0001, d = 0.60], and RSI scores from 21 [8, SD] to 14.4 [8.2, SD], [t = 6.71, p < 0.001, d = 0.75] were seen following treatment, with moderate effect sizes. 17% of patients taking pregabalin did not report improvement, with 1% reporting worsening cough. Side effects requiring discontinuation of therapy were reported in 4% of patients. Presence of hiatal hernia, dysmotility or reflux findings did not change the likelihood of positive response (75% [no findings] vs. 80% [positive findings]). Sex did not affect likelihood of improvement (female 82% vs. male 85%, p = n.s). CONCLUSION: Pregabalin is a well-tolerated neuromodulator providing relief of CNC symptoms in patients presenting to an Otolaryngology clinic. Treatment duration of 6 weeks provides relief to more than three quarters of patients and response to therapy occurs equally across genders and in those with gastrointestinal comorbidities.