Chronic cough: new insights and future prospects

Alyn Morice, Peter Dicpinigaitis, Lorcan McGarvey, Surinder S Birring

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Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review.The estimated global prevalence of chronic cough is 2-18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden for the patient and healthcare systems. RCC diagnosis and treatment are often delayed for many years as potential treatable triggers must be excluded first and a stepwise empirical therapeutic regimen is recommended.Evidence supporting most currently recommended treatments is limited. Many treatments do not address the underlying pathology, are used off-label, have limited efficacy and produce significant side-effects. There is therefore a significant unmet need for alternative therapies for RCC that target the underlying disease mechanisms. Early clinical data suggest that antagonists of the purinergic P2X3 receptor, an important mediator of RCC, are promising, though more evidence is needed.
Original languageEnglish
Article number 210127
Number of pages18
JournalEuropean Respiratory Review
Issue number162
Early online date30 Nov 2021
Publication statusEarly online date - 30 Nov 2021


  • Cough - diagnosis - drug therapy - epidemiology
  • Adult
  • Humans
  • Quality of Life
  • Chronic Disease


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