Continuous cough monitoring beneficial in chronic cough trial

Key takeaways:

• Continuous cough monitoring allows for assessment of immediate treatment effects in patients with refractory chronic cough.
• Constant monitoring also provides researchers with large amounts of data.

In a trial evaluating a refractory chronic cough treatment, continuous cough monitoring allowed researchers access to an abundance of data and the treatment’s impact over time, according to a presentation at the Hyfe Cough Science Forum.

In an exploratory clinical trial, David A. Edwards, PhD, associate in bioengineering at Harvard University, and colleagues assessed 12 patients with refractory chronic cough to evaluate the impact of daily alkaline hypertonic divalent salts (HDS), consisting of calcium and magnesium, on cough through digital cough monitoring.

Edwards noted during his presentation that cough is evoked through dry and dirty air, meaning that moisture in the throat could help hydrate the larynx, reduce inflammation and prevent coughing.

Researchers captured cough data at baseline (1 week), 1 week after using placebo (nasal saline) and 1 week after using the alkaline HDS spray.

“There’s an opportunity here for a first-line treatment, really safe, of chronic cough, possibly effective across cough rates,” Edwards said.

Clinical results of this study are planned to be presented at a future meeting, so during the Cough Science Forum, Edwards explained several benefits of continuous cough monitoring in the trial.

The first benefit was inter- and intra-subject placebo-adjusted efficacy. According to Edwards, using a device that monitors cough hourly allowed the researchers to have access to lots of data to compare placebo vs. treatment.

“It gives us two angles on the efficacy, and it generates a lot of data in a small study,” Edwards said.

The ability to see the effect of the treatment with time is another benefit of continuous cough monitoring since it is constantly collecting data, Edwards said. With this feature, researchers can also assess the immediate impact of placebo and treatment on cough in each individual patient.

In terms of troubleshooting, researchers can see real-time information with this type of monitoring via the Hyfe cough tracking app.

“Whether blinded or nonblinded, the research team has access to the digital cough counts, which allows us to troubleshoot,” Edwards said. “One of the challenges with digital clock monitoring is, ‘Is it on?’ and ‘Are there any issues with the user using it?’ and it’s very helpful to be able to see that in real time.”

Lastly, the nature of continuous/constant monitoring presents an opportunity for evaluation of cough stability on an hourly or daily basis, as well as evaluation of daytime vs. nighttime treatment effect.

“It seems to me a benefit of the daily monitoring is your ability to discount the problem of variability,” Edwards said.