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All Studies   Meta Analysis    Recent:   

The effectiveness of gabapentin and gabapentin/montelukast combination compared with dextromethorphan in the improvement of COVID‐19‐ related cough: A randomized, controlled clinical trial

Soltani et al., The Clinical Respiratory Journal, doi:10.1111/crj.13529
Jul 2022  
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Hospitalization time 20% Improvement Relative Risk Recovery, BCSS 25% Recovery, VAS 21% Montelukast  Soltani et al.  LATE TREATMENT  RCT Is late treatment with montelukast beneficial for COVID-19? RCT 127 patients in Iran (April - May 2020) Shorter hospitalization (p=0.011) and improved recovery (p=0.00056) c19early.org Soltani et al., The Clinical Respirato.., Jul 2022 Favorsmontelukast Favorscontrol 0 0.5 1 1.5 2+
28th treatment shown to reduce risk in November 2021
 
*, now with p = 0.0045 from 8 studies.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 81 treatments. c19early.org
RCT 180 hospitalized COVID-19 patients showing improved cough frequency and severity with gabapentin and gabapentin/montelukast compared to dextromethorphan, with the combination being more efficacious. The gabapentin/montelukast group had a significantly greater reduction in cough frequency (measured by the Breathlessness, Cough, and Sputum Scale) compared to the gabapentin alone group. There was no significant difference between the two groups in cough severity reduction measured by Visual Analog Scale.
hospitalization time, 20.0% lower, relative time 0.80, p = 0.01, treatment median 8.0 IQR 3.0 n=51, control median 10.0 IQR 7.0 n=76.
risk of no recovery, 25.0% lower, RR 0.75, p < 0.001, treatment mean 1.96 (±0.69) n=51, control mean 1.47 (±0.81) n=76, relative BCSS improvement, GPT/MTL vs. GPT.
risk of no recovery, 20.6% lower, RR 0.79, p = 0.07, treatment mean 1.8 (±1.11) n=51, control mean 1.43 (±1.13) n=76, relative VAS improvement, GPT/MTL vs. GPT.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Soltani et al., 31 Jul 2022, Randomized Controlled Trial, Iran, peer-reviewed, mean age 56.8, 6 authors, study period April 2020 - May 2020. Contact: atousahakamifard@sbmu.ac.ir.
This PaperMontelukastAll
The effectiveness of gabapentin and gabapentin/montelukast combination compared with dextromethorphan in the improvement of COVID‐19‐ related cough: A randomized, controlled clinical trial
Rasool Soltani, Sara Nasirharandi, Farzin Khorvash, Maryam Nasirian, Kian Dolatshahi, Atousa Hakamifard
The Clinical Respiratory Journal, doi:10.1111/crj.13529
Introduction: Cough is one of the most common presenting symptoms of COVID-19, which can persist for weeks or months. Objective: The goal of this study was to evaluate the effectiveness of gabapentin (GBT) alone and in combination with montelukast (MTL) for improving cough. Methods: In this open-label randomized controlled clinical trial, eligible cases were patients hospitalized with moderate to severe COVID-19 who had cough with a Breathlessness, Cough, and Sputum Scale (BCSS) score of at least 2 based on its cough subscale. The participants were randomly assigned to three groups including two experimental groups and one control group. The first and second experimental groups received GBT and GBT/MTL, respectively, whereas the control group received dextromethorphan (DXM). Treatment duration was 5 days in all groups. Before and after the interventions, the severity of cough was evaluated using BCSS scale and Visual Analog Scale (VAS). Results: A total of 180 patients were included; GPT, GPT/MTL, and DXM consisted of 76, 51, and 53 patients, respectively. There was no significant difference between the three groups in terms of age, gender, and comorbidities (P > 0.05). Regarding BCSS and VAS scores, there was significant reduction from the baseline values in all groups (P < 0.0001), with the change rate being significantly higher in DXM group. The amount of reduction of BCSS in the GPT/MTL group was significantly more than the GPT group, whereas there was no significant difference between the two groups regarding VAS score. Although the duration of hospitalization differed between the groups with the GPT/MTL group having the shortest duration, the difference was statistically significant only between the GPT and GPT/MTL groups (P < 0.0001).
CONFLICT OF INTEREST The authors declare no conflict of interest. AUTHOR CONTRIBUTIONS Rasool Soltani and Atousa Hakamifard designed the study, Sara Nasirharandi and Farzin Khorvash performed the study. Sara Nasirharandi collected the data. Maryam Nasirian analyzed the data. Rasool Soltani wrote the first draft of the manuscript. All authors have read and approved the final manuscript. ETHICS STATEMENT The study was approved by the ethics committee of Isfahan University of Medical Sciences (ethics code: IR. MUI.MED.REC.1399.952).
References
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Stelmach, Korzeniewska, Stelmach, Majak, Grzelewski et al., Effects of montelukast treatment on clinical and inflammatory variables in patients with cystic fibrosis, Ann Allergy Asthma Immunol, doi:info:doi/10.1016/S1081-1206(10)61156-8
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Late treatment
is less effective
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