Assessing the effect of flurbiprofen on cough reflex sensitivity in subjects with upper respiratory tract infection.

Résumé fourni par la source

Acute upper respiratory tract infection (URTI) frequently induces cough hypersensitivity and is associated with the release of inflammatory prostanoids such as PGE₂. Prostanoids sensitize airway sensory nerves and may contribute to cough hypersensitivity. Whilst flurbiprofen is effective for URTI sore throat, its impact on acute cough hypersensitivity and urge-to cough is unknown. To assess the efficacy of flurbiprofen on reducing URTI- induced urge‑to‑cough and acute cough hypersensitivity, and associated changes in oropharyngeal prostanoids. 81 adults with current URTI and cough or urge-to-cough were randomised to flurbiprofen lozenge (8.75 mg; n=20), placebo lozenge (n=20), low‑dose spray (2.92 mg; n=20), or full‑dose spray (8.75 mg; n=21). Capsaicin cough sensitivity (Cu, C2, C5) was measured at baseline and 180 min. Symptoms were recorded every 30 min using the Cold Symptom Questionnaire (CSQ) and Patient Global Impression of Change (PGIC). Pharyngeal lavage samples were analysed by LC‑MS/MS to quantify prostanoids. Flurbiprofen (all formulations) significantly reduced C5 at 180 mins, while placebo showed no change. Both spray doses increased urge-to-cough threshold (Cu), with the 8.75 mg spray outperforming the low‑dose spray. High-dose spray outperformed low-dose spray on CSQ scores, and all formulations improved PGIC ratings and reduced PGE₂ levels. No serious adverse events occurred. Flurbiprofen produced significant improvements in cough reflex sensitivity and subjective cough outcomes in URTI, with the full‑dose spray demonstrating the greatest benefit. Effects aligned with reduced pharyngeal PGE2, supporting a mechanism involving reduced sensory nerve sensitisation. Future studies will assess the full efficacy of flurbiprofen as a novel therapy for acute cough in URTI.

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