Orvepitant delivers sustained improvements in chronic refractory cough
Treatment with the neurokinin-1 receptor antagonist orvepitant appears to be safe in patients with chronic refractory cough, yielding sustained improvements in cough frequency and severity, according to the results of the phase II VOLCANO-1 trial.
Thirteen patients with daytime cough frequency of >3 to <250 coughs/hour received orvepitant 30 mg once daily for 4 weeks. Objective cough frequency was measured over 24 hours at several time points: baseline and weeks 1, 4, and 8.
The primary outcome was change in daytime cough frequency at week 4. Secondary outcomes included cough severity score on visual analogue scale (VAS), global ratings of change for cough frequency and severity, and Cough-specific Quality of Life Questionnaire score.
Mean objective daytime cough frequency at baseline was 71.4/hour. This improved by 26 percent at week 4, translating to a decrease of 18.9 coughs/hour (95 percent CI, 9.6–28.3; p<0.001).
The improvement was already evident during the first week of treatment (reduction from baseline of 38 percent or 27.0 coughs/hour, 11.4–42.7; p=0.001) and sustained after drug discontinuation through week 8 (reduction of 29 percent or 20.4 coughs/hour, 3.2–37.5; p=0.020). There were significant, parallel improvements seen in severity VAS and quality of life scores.
These findings show that orvepitant merits further clinical investigation, according to researchers.