The role of bradykinin as a pathogenetic target and prospects for pharmacological correction of cough associated with angiotensin-converting enzyme inhibitors: results of an open-ended prospective observational program

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Abstract

Cough induced by angiotensin-converting enzyme (ACE) inhibitors is a common side effect that can be managed with antitussive therapy.

The aim: to evaluate the efficacy of antitussive drug Rengalin® in the treatment of cough induced by long-term use of an ACE inhibitors.

Material and methods. The study included 30 patients with persistent cough associated with ACE inhibitor use. Participants received Rengalin®, two tablets twice daily, for 28 days, while maintaining their ACE inhibitor intake. During visits 1–5 (days 1, 7, 14, 21, and 28 of the observation period), patients were examined, cough severity was assessed, completion of the cough severity Scale in the patient’s diary was verified, and concomitant therapy was recorded. From the second visit, data on adverse events was collected, and treatment efficacy was assessed. The primary endpoint was change in cough severity on days 7, 14, 21, and 28 of the treatment and observation. Additionally, the influence of therapy at nighttime and daytime cough, proportion of patients without cough, and time to cough resolution were estimated.

Results. After a 28-day course of Rengalin® intake, a decrease in cough severity from 6.7 to 0.1 points was observed (p <0.0001). Antitussive effect of the drug was fixed on the 7th day of therapy, with a decrease in cough severity from 6.7 to 5.0 points. Cough resolution (both daytime and nighttime) was recorded in 27 patients (90%) by the 21st day of treatment, and in 29 patients (96.7%) by the 28th day of treatment. No serious adverse events of the studied drug or negative impact on vitally important indexes were recorded.

Conclusion. Rengalin® demonstrated a significant antitussive effect in patients with ACE inhibitor-induced cough, achieving almost complete relief of this symptom in most patients by the end of the 4-week course of therapy. This may take place due to its regulatory effect on bradykinin receptors.

About the authors

Sergey L. Babak

Russian University of Medicine of the Ministry of Healthcare of Russia

Author for correspondence.
Email: sergbabak@mail.ru
ORCID iD: 0000-0002-6571-1220
SPIN-code: 5213-3620
Scopus Author ID: 45560913500
ResearcherId: KAO-3183-2024

MD, Dr. Sci. (Medicine), associate professor, professor of the Department of phthisiology and pulmonology of N.A. Semashko Scientific and Educational Institute of Clinical Medicine, pulmonologist

Russian Federation, Moscow

Marina V. Gorbunova

Russian University of Medicine of the Ministry of Healthcare of Russia

Email: mgorb@mail.ru
ORCID iD: 0000-0002-2039-0072
SPIN-code: 6699-1286
Scopus Author ID: 45561369300

MD, Dr.Sci. (Medicine), associate professor of the Department of phthisiology and pulmonology of N.A. Semashko Scientific and Educational Institute of Clinical Medicine, pulmonologist

Russian Federation, Moscow

Andrey G. Malyavin

Russian University of Medicine of the Ministry of Healthcare of Russia

Email: sergbabak@mail.ru

MD, Dr. Sci. (Medicine), professor of the Department of phthisiology and pulmonology of N.A. Semashko Scientific and Educational Institute of Clinical Medicine, pulmonologist, general secretary of the Russian Scientific Medical Society of Internal Medicine, chief pulmonologist of the Ministry of Healthcare of Russia for the Central Federal District

Russian Federation, Moscow

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