Montelukast Sodium Combination Therapy Significantly Improves Outcomes in Pediatric Cough Variant Asthma

A recent meta-analysis has demonstrated the clinical efficacy of montelukast sodium combination therapy for children with cough variant asthma (CVA). This study reviewed 18 clinical trials from Chinese populations, comparing combination therapy (montelukast sodium plus standard treatments) to control treatments, which included budesonide, fluticasone propionate, salmeterol-fluticasone, or ketotifen alone.
The analysis revealed that the combination therapy group had a significantly higher effective treatment rate (relative ratio [RR]: 1.23, 95% confidence interval [CI]: 1.18-1.29, p < 0.001) than the control group, with no significant difference in adverse reactions between groups (RR: 0.65, 95% CI: 0.42-1.02, p = 0.060). 
Pulmonary function parameters, including peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratios, were significantly improved in the combination therapy group compared to controls (p < 0.001).
Moreover, the combined therapy resulted in significantly lower levels of inflammatory markers, including tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and IgE, indicating better control of airway inflammation (p < 0.001).
This meta-analysis highlights that montelukast sodium, when used alongside standard asthma treatments, provides superior clinical outcomes in managing pediatric CVA. These findings support the use of combination therapy as a practical approach to improving both respiratory function and inflammation control in children with CVA.
 

Fruit-Flavored E-Cigarettes Linked to Increased Risk of Nocturnal Dry Cough

Although in vitro and animal studies have identified the pulmonary toxicity of electronic cigarette (ECIG) flavors, epidemiological evidence on their respiratory effects remains limited. This study explored the longitudinal association between exposure to flavored ECIGs and the occurrence of nocturnal dry cough among users using data from the Population Assessment of Tobacco and Health Study (2014-2019).
 A secondary analysis was conducted on 18,925 adults, totaling 38,638 observations, employing weighted-incidence estimates and generalized estimating equation models to assess both unadjusted and adjusted associations.
Findings revealed that the weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP: 16.6%) and former fruit-flavored ECIG users (WIP: 16.6%) compared to non-ECIG users (WIP: 11.1%). Current users of fruit-flavored ECIGs had a 40% higher risk of reporting nocturnal dry cough compared to non-users (aRR: 1.40). Former ECIG users of multiple flavors and other flavors had a markedly increased risk of cough, with 300% and 66% higher risks, respectively (aRR: 3.33 and aRR: 1.66).
The significant association between fruit-flavored ECIG use and increased risk of nocturnal dry cough highlights a potential early indicator of respiratory inflammation and disease risk, raising concerns about the respiratory health impact of flavored ECIGs. Further studies are needed to assess the long-term implications of these findings on respiratory health.
 

Sediflù may be Effective for Pediatric Cough, suggests SEPEDIA Clinical Trial

This pilot randomized, double-blind, placebo-controlled, multicenter clinical trial evaluated the efficacy and tolerability of Sediflù, a herbal-based medical device, in treating persistent nocturnal and diurnal cough in children aged 3 to 7 days with either dry or productive cough. The study enrolled pediatric patients experiencing upper respiratory tract infections, assigning them to receive either Sediflù or a placebo.

The primary outcomes included the assessment of Sediflù’s soothing effects on dry and productive coughs both during the day and at night, alongside evaluating cough-related impacts on sleep quality for both the child and their parents, as well as cough frequency and severity.

Results demonstrated significant improvements in both nocturnal and diurnal cough scores in the Sediflù group starting from day 2, with marked reductions in daytime cough severity observed at days 3 and 7. Sediflù was well-tolerated, and its use was associated with notable enhancements in the quality of sleep for both children and their parents.

These findings suggest that Sediflù syrup may serve as an effective and well-tolerated treatment option for managing persistent coughs in young children with upper respiratory infections, potentially reducing cough duration and improving overall quality of life for affected families.

Recent medical technologies in the management of cough

Recent research indicated that Eladis® exhibited overall effectiveness and a statistically significant superiority compared to the placebo. The data from this study were presented in the journal Terapevticheskii arkhiv.

This phase III clinical trial enrolled 250 individuals aged 18 to 65 years suffering from acute respiratory viral infections with acute bronchitis or upper respiratory tract involvement. Participants were randomly assigned into two groups of 125: one group received Eladis® (40 mg tablets), while the other group received a placebo. The study drugs were administered as one tablet twice daily for a duration of seven to fourteen days. Following the treatment, patients were followed up (on day 7±2) to evaluate the therapy effects on the frequency and intensity of daytime and nighttime cough, the frequency of coughing episodes, the severity of cough, the duration until clinical resolution of cough, and the effect on the severity of the main symptoms associated with acute respiratory viral infections.

Significant differences were observed among the study groups in the percentage of patients who achieved a reduction in coughing attack frequency by 50% or more by day five (p value <0.0001). Additionally, the Eladis® group demonstrated clinical resolution of cough two days earlier, with a median time of six days compared to eight days in the placebo group. By day five of treatment, there was a substantial decrease in both the frequency and severity of cough attacks, exceeding 3.5 points. All these effects were correlated with the drug's high safety profile.

Therefore, Eladis® demonstrated overall efficacy and a statistically significant benefit in comparison to the placebo.