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Codeine No Better Than Placebo for Cough in COPD Patients

Study finds no benefit in stable patients with chronic obstructive pulmonary disease

THURSDAY, April 27 (HealthDay News) -- Although codeine is the standard by which new treatments are judged, the drug is no better than a placebo in treating coughs in patients with chronic obstructive pulmonary disease (COPD), according to a study in the April issue of the Journal of Allergy and Clinical Immunology.

Jaclyn Smith, M.D., Ph.D., of South Manchester University Hospitals Trust in Manchester, England, and colleagues conducted a study of 21 patients with physician-diagnosed, stable disease who complained of cough. The sample was 76.9 percent male, with a mean age of 67.7 years, a mean predicted FEV1 of 53.4 percent and a median smoking history of 43.5 pack years.

The study comprised a cough challenge (single breath, citric acid), 10-hour daytime ambulatory and overnight cough recordings, subjective cough scores and visual analog scores at baseline and on two study days, one week apart. At the start of each cough recording, patients were given 60 mg of codeine phosphate or a placebo.

When codeine was compared with placebo, there were no significant differences in cough challenge thresholds, time spent coughing nor subjective cough measures.

"Unlike postviral cough, cough rates in stable COPD are not likely to improve over time. We tested for a significant change in cough rate in relation to the order of treatment and found none," the authors conclude.

The study was funded by a grant from GlaxoSmithKline.

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