Injection treatment for chronic cough relief

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study evaluates the effectiveness of an office-based injection of a local anesthetic and steroid combination targeting the superior laryngeal nerve to reduce cough frequency and alleviate symptoms in patients with neurogenic cough. Neurogenic cough is a chronic condition often resulting from nerve irritation, typically following a viral upper respiratory infection. Current treatments involve medications that can be sedating and poorly tolerated, making this nerve block approach a potential alternative. The study aims to assess the impact of this intervention on a larger patient population, building on previous findings that indicated symptom improvement in a smaller cohort.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 18 years or older
* Ability of patients to speak and understand English
* Ability for patients to consent for themselves
* Cough for 8 weeks or greater, with suspected sensory neuropathic etiology of the cough. Inclusion based on history of preceding upper respiratory infection or other symptoms suggestive of irritable larynx such as cough in response to temperature changes, odors, scents/perfumes, tickle, irritation in the throat/paralaryngeal region, or talking.
* Persistent cough despite treatment of ALL the major contributors of cough (items listed below would be done as part of a standard clinical workup for chronic cough and are not done specific to this study):

  * Reflux disease treatment with one of the following: failure of two months of PPIs OR negative pH study
  * Asthma: lack of response to at least one month of steroid inhaler/bronchodilator OR normal PFTs/negative methacholine challenge + negative CXR/CT
  * Upper airway cough syndrome/Allergic disease: lack of response to at least one month of antihistamines/decongestants/nasal steroids OR negative allergy testing (skin or serum) OR lack of response to at least one year of immunotherapy/allergy shots

Exclusion Criteria:

* Age less than 18 years
* Patients unable or unwilling to provide informed consent
* Known etiology to cough other than sensory neuropathy (e.g., reflux disease, asthma, allergic rhinitis, chronic obstructive pulmonary disease)
* Addition of new neuromodulators at the time of the injection. Patients who were already being treated with neuromodulators for their cough (e.g., gabapentin, amitriptyline) will not be excluded provided their dose remains constant.
* Nissen fundoplication within the last year
* Smoking history within last 5 years
* Allergy to bupivacaine or Kenalog-40

Where it's running

• University of Alabama at Birmingham
  Birmingham, Alabama, United States Recruiting

Study contacts

• Principal investigator: Blake Simpson, MD — University of Alabama at Birmingham
• Study coordinator: Blake Simpson, MD
• Email: blakesimpson@uabmc.edu
• Phone: (205) 801-7863

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.