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Guilleminault L, Grassin-Delyle S, Mazzone SB. Drugs Targeting Cough Receptors: New Therapeutic Options in Refractory or Unexplained Chronic Cough. Drugs 2024:10.1007/s40265-024-02047-y. [PMID: 38904926 DOI: 10.1007/s40265-024-02047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/22/2024]
Abstract
Refractory chronic cough is a disabling disease with very limited therapeutic options. A better understanding of cough pathophysiology has led to the development of emerging drugs targeting cough receptors. Recent strides have illuminated novel therapeutic avenues, notably centred on modulating transient receptor potential (TRP) channels, purinergic receptors, and neurokinin receptors. By modulating these receptors, the goal is to intervene in the sensory pathways that trigger cough reflexes, thereby providing relief without compromising vital protective mechanisms. These innovative pharmacotherapies hold promise for improvement of refractory chronic cough by offering improved efficacy and potentially mitigating adverse effects associated with current recommended treatments. A deeper comprehension of their precise mechanisms of action and clinical viability is imperative for optimising therapeutic interventions and elevating patient care standards in respiratory health. This review delineates the evolving landscape of drug development in this domain, emphasising the significance of these advancements in reshaping the paradigm of cough management.
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Affiliation(s)
- Laurent Guilleminault
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM UMR1291, CNRS UMR5051, University Toulouse III, 31024, Toulouse, France.
- Department of Respiratory Medicine, Faculty of Medicine, Hôpital Larrey, Toulouse University Hospital, 24 chemin de Pouvourville, 31059, Toulouse, France.
| | - Stanislas Grassin-Delyle
- Exhalomics®, Hôpital Foch, Suresnes, France
- Département de Biotechnologie de la Santé, Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Montigny le Bretonneux, France
| | - Stuart B Mazzone
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, VIC, Australia
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Fan Y, Zhang X, Zhang Q, Zheng L, Zhou R, Sun C, Wang X, Song K, He Z, Wang H, Zhang Q, Hu W. Safety and Pharmacokinetics of HRS-2261, a P2X3 Receptor Antagonist, in Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled Phase 1 Study. Clin Pharmacokinet 2024; 63:293-302. [PMID: 38198010 DOI: 10.1007/s40262-023-01330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND P2X3 receptor antagonists hold promising potential as a therapeutic option for patients with refractory or unexplained chronic cough, a condition lacking approved therapies. This study assessed the safety, tolerability, and pharmacokinetics (PK) of HRS-2261, a novel selective P2X3 receptor antagonist, in healthy subjects. METHODS This randomized, double-blinded, placebo-controlled phase 1 trial of HRS-2261 consisted of three phases: the single ascending dose (SAD) study phase, the food-effect study phase, and the multiple ascending dose (MAD) study phase. In the SAD phase, healthy subjects were randomly assigned to receive a single oral dose of HRS-2261 (25, 100, 200, 400, 800, and 1200 mg) or placebo. Subjects in the 200 mg group of the SAD phase progressed directly to the food-effect phase following safety evaluation. In the MAD phase, healthy subjects were randomized to receive HRS-2261 (50, 200, and 400 mg) or placebo twice daily for 14 consecutive days. The primary endpoints were safety and tolerability. RESULTS A total of 62 and 30 subjects were enrolled in the SAD and MAD phases, respectively, with 12 subjects from the SAD phase transitioning to the food-effect phase. The incidence and severity of adverse events (AEs) were not dose dependent, and most AEs were mild except for one moderate AE (epididymitis, which was not related to treatment) in the 400 mg group. Dysgeusia was reported in nine subjects, including two from the SAD phase, one from the food-effect phase, and six from the MAD phase. The median Tmax and geometric mean t1/2 were 0.9-2.0 h and 4.1-8.5 h in the SAD, and 2.0-2.7 h and 4.6-5.0 h on day 14 in the MAD, respectively. Drug exposures in the SAD and MAD phases were both less than dose proportional. The accumulation of the drug was slight with repeated twice-daily dosing. Food-effect study results showed that food intake did not affect the plasma exposure of HRS-2261. CONCLUSIONS HRS-2261 demonstrated good tolerability, with a low incidence of dysgeusia. The PK profile was favorable. This study supports further development of HRS-2261 as a potential P2X3 receptor antagonist for chronic cough. TRIAL REGISTRATION NUMBER Clinical trials.gov, identifier: NCT05274516. Trial registration date: March 10, 2022.
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Affiliation(s)
- Yuru Fan
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Xuan Zhang
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Qin Zhang
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Liang Zheng
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Renpeng Zhou
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Cheng Sun
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China
| | - Xihan Wang
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Ke Song
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Zhusheng He
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Honghui Wang
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Qian Zhang
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China.
| | - Wei Hu
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, China.
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