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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'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Cough '
'is one of the most common presenting symptoms of COVID‐19, which can persist for weeks or '
'months.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>The goal of '
'this study was to evaluate the effectiveness of gabapentin (GBT) alone and in combination '
'with montelukast (MTL) for improving '
'cough.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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\u2009days in all groups. '
'Before and after the interventions, the severity of cough was evaluated using BCSS scale and '
'Visual Analog Scale '
'(VAS).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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 (<jats:italic>P</jats:italic>\u2009>\u20090.05). Regarding BCSS '
'and VAS scores, there was significant reduction from the baseline values in all groups '
'(<jats:italic>P</jats:italic>\u2009<\u20090.0001), 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 '
'(<jats:italic>P</jats:italic>\u2009<\u2009'
'0.0001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>GPT, both '
'alone and in combination with MTL, improves cough frequency and severity in hospitalized '
'patients with COVID‐19, with the combination being more efficacious. This regimen may be '
'useful in patients who cannot tolerate opioids.</jats:p></jats:sec>',
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