Pulmonology Daily Report: 01/15/2024

The PACIFY COUGH study, a phase 2, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trial investigated the effect of low dose controlled-release morphine in 44 patients with idiopathic pulmonary fibrosis, characterized by a diagnosis within 5 years, self-reported cough lasting more than 8 weeks, and a cough visual analogue scale score of 30 mm or higher (1). The study found that morphine reduced objective awake cough frequency by 39.4% (95% CI -54.4 to -19.4; p=0.0005) compared with placebo, with mean daytime cough frequency reduced from 21.6 coughs per hour at baseline to 12.8 coughs per hour with morphine, whereas cough rates did not change with placebo (21.5 coughs per hour to 20.6 coughs per hour). Adverse events were more frequent in the morphine group (40%) compared to the placebo group (14%), with nausea and constipation being the main side effects.

Reference

Wu Z, Spencer LG, Banya W, Westoby J, Tudor VA, Rivera-Ortega P, Chaudhuri N, Jakupovic I, Patel B, Thillai M, West A, Wijsenbeek M, Maher TM, Smith JA, Molyneaux PL. Morphine for treatment of cough in idiopathic pulmonary fibrosis (PACIFY COUGH): a prospective, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trial. Lancet Respir Med. 2024 Jan 15:S2213-2600(23)00432-0. doi: 10.1016/S2213-2600(23)00432-0. Epub ahead of print. PMID: 38237620.