Roxana Siles, MD, FAAAAI, staff in the Department of Allergy and Immunology at Cleveland Clinic and codirector of the Asthma Center at Cleveland Clinic, discusses the important need for chronic cough therapies and what issues with current treatments should be addressed by next-generation medications.
There is a great need for therapies that minimize the adverse reactions of currently available chronic cough treatments, especially for those who require daily therapy, emphasized Roxana Siles, MD, FAAAAI, staff in the Department of Allergy and Immunology at Cleveland Clinic and codirector of the Asthma Center at Cleveland Clinic.
Transcript
Given the challenges of a placebo effect, do you expect to see an FDA-approved therapy for chronic cough within the next few years?
I do, because I do think that there is a big need to address the patients who have refractory or unexplained cough; there’s good overlap between those 2 names. I definitely think that there’s a need, and certainly there was effectiveness that was shown [for gefapixant]. I think we do have to be careful of the adverse reactions, side effects, just like we do with any drug. But certainly, we do need a form of therapy that helps minimize the other side effects that we talked about, including the sedation and the other effects that we see with what we have available at this time.
Because most of these patients do cough every day, they do often require a daily form of therapy. And again, unfortunately, because a lot of these patients have a little bit of acid reflux, they might have asthma, it means not just 1 medication, and I think that’s the challenge, right? How do we stay on the regimen? Cost of medication is always something to think about also, and then again, minimizing the adverse reactions, which can occur with anything that we prescribe.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
Read More