Efficacy and safety of neurokinin-1 receptor antagonist on cough suppression: a systematic review and meta-analysis
4 affiliations
- 1Department of Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China , ,
- 2Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, State Key Laboratory of Respiratory Health and Multimorbidity, Sichuan University, Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University , ,
- 3Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China , ,
- 4Department of Breast Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China , ,
Abstract
Introduction: The efficacy and safety of neurokinin-1 (NK-1) receptor antagonist in adults with cough remain unclear. Our objective was to systematically assess the efficacy and safety of NK-1 receptor antagonist for cough treatment using the latest available clinical evidence.
Methods: A comprehensive literature retrieval was conducted across PubMed, Embase (via Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), and the ClinicalTrials.gov registry, encompassing data from database inception through 10 March 2026. This search aimed to identify randomized controlled trials (RCTs) assessing the therapeutic utility of NK-1 receptor antagonists in cough management. The abstracts and full-text articles were screened based on predefined inclusion and exclusion criteria. Meta-analysis was performed using R software (V 4.4.2). Main outcomes included the cough visual analog scale (VAS), awake objective cough frequency, urge to cough scale, 24-h cough frequency, and cough-specific patient-reported scale. Adverse events were also pooled.
Results: Five RCTs comprising a total 719 participants were included, evaluating three NK-1 receptor antagonists: aprepitant, orvepitant, and serlopitant. Compared to placebo, NK-1 receptor antagonists demonstrated significant antitussive efficacy by improving cough VAS scores (mean difference [MD] = −6.90, 95 CI (−10.90, −2.90), p < 0.0001) and cough-specific patient-reported scale (standardized mean difference [SMD] = 0.50, 95 CI (0.22, 0.78), p < 0.0001). Notably, the treatment group experienced a significant reduction in the urge to cough scale (SMD: −0.31, 95% CI (−0.40, - group (RR: 1.33, 95% CI (1.15, 1.53), p < 0.0001).No significant difference was detected at the overall effect estimates of objective cough frequency.
Conclusion: NK-1 receptor antagonists provide modest improvements in patient-reported subjective cough outcomes, but show no statistically significant reduction in objective cough frequency. Given the small evidence base, clinical heterogeneity among pooled conditions, and higher incidence of mild adverse events, conclusions regarding their clinical benefit must be drawn with caution. Large-scale, high-quality clinical studies are required to confirm their efficacy and safety.
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BibTeX
@article{yang2026efficacy,
title = {{Efficacy and safety of neurokinin-1 receptor antagonist on cough suppression: a systematic review and meta-analysis}},
author = {Ye Yang and Ji Wang and Zhiqiang Hu and Gang Wang and Junjie Li},
journal = {Frontiers in pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1915023},
url = {https://europepmc.org/article/PMC/PMC13670168},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy and safety of neurokinin-1 receptor antagonist on cough suppression: a systematic review and meta-analysis
AU - Ye Yang
AU - Ji Wang
AU - Zhiqiang Hu
AU - Gang Wang
AU - Junjie Li
PY - 2026
DA - 2026/10/01
JO - Frontiers in pharmacology
DO - 10.3389/fphar.2026.1915023
UR - https://europepmc.org/article/PMC/PMC13670168
AB - Introduction: The efficacy and safety of neurokinin-1 (NK-1) receptor antagonist in adults with cough remain unclear. Our objective was to systematically assess the efficacy and safety of NK-1 receptor antagonist for cough treatment using the latest available clinical evidence. Methods: A comprehensive literature retrieval was conducted across PubMed, Embase (via Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), and the ClinicalTrials.gov registry, encompassing data from database inception through 10 March 2026. This search aimed to identify randomized controlled trials (RCTs) assessing the therapeutic utility of NK-1 receptor antagonists in cough management. The abstracts and full-text articles were screened based on predefined inclusion and exclusion criteria. Meta-analysis was performed using R software (V 4.4.2). Main outcomes included the cough visual analog scale (VAS), awake objective cough frequency, urge to cough scale, 24-h cough frequency, and cough-specific patient-reported scale. Adverse events were also pooled. Results: Five RCTs comprising a total 719 participants were included, evaluating three NK-1 receptor antagonists: aprepitant, orvepitant, and serlopitant. Compared to placebo, NK-1 receptor antagonists demonstrated significant antitussive efficacy by improving cough VAS scores (mean difference [MD] = −6.90, 95 CI (−10.90, −2.90), p < 0.0001) and cough-specific patient-reported scale (standardized mean difference [SMD] = 0.50, 95 CI (0.22, 0.78), p < 0.0001). Notably, the treatment group experienced a significant reduction in the urge to cough scale (SMD: −0.31, 95% CI (−0.40, - group (RR: 1.33, 95% CI (1.15, 1.53), p < 0.0001).No significant difference was detected at the overall effect estimates of objective cough frequency. Conclusion: NK-1 receptor antagonists provide modest improvements in patient-reported subjective cough outcomes, but show no statistically significant reduction in objective cough frequency. Given the small evidence base, clinical heterogeneity among pooled conditions, and higher incidence of mild adverse events, conclusions regarding their clinical benefit must be drawn with caution. Large-scale, high-quality clinical studies are required to confirm their efficacy and safety.
SN - 1663-9812
ER -