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To recognize the therapeutic predictors of baclofen (skeletal muscle relaxant) therapy for refractory chronic cough due to gastroesophageal reflux.
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.
Respiratory Medicine
Pressure and length of the lower esophageal sphincter as predictive indicators of therapeutic efficacy of baclofen for refractory gastroesophageal reflux-induced chronic cough
Yiqing Zhu et al.
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