In a quest to recognize the clinical predictors of efficacy of baclofen as therapy for gastroesophageal reflux-induced chronic cough (GERC), this prospective clinical study found lower esophageal sphincter pressure and length to be independent predictors of efficacy of baclofen.

To recognize the therapeutic predictors of baclofen (skeletal muscle relaxant) therapy for refractory chronic cough due to gastroesophageal reflux.

All the 138 patients with suspected refractory GERC undertook esophageal motility study and multichannel intraluminal impedance along with pH testing to ascertain the diagnosis. They were treated with baclofen. The application of logistic regression analysis was useful in the recognition of its therapeutic predictors.

About 52.2% (72 out of 138 patients) had an overall response rate to baclofen therapy. Its efficacy was determined via independent predictors- lower esophageal sphincter length (LESL) and pressure (LESP).

The ideal cut-off value for the prediction of baclofen efficacy for LESP was 11 mmHg and for LESL it was 2.35 cm with a sensitivity and specificity as mentioned in the below table 1:

The joint use of LESP and LESL was useful in achieving the highest predictive specificity i.e. 90.7%. 

The length and pressure of the lower esophageal sphincter i.e. LESP and LESL can be effective therapeutic predictors of baclofen therapy in refractory GERC. Both LESP and LESL may be used to screen patients and can assist in the betterment of therapeutic precision.