Thalidomide relieves disabling cough for people with deadly lung disease, study shows

September 17, 2012

In the first clinical trial to demonstrate an effective treatment for constant, disabling cough among people with idiopathic pulmonary fibrosis (IPF), researchers at the Johns Hopkins University School of Medicine found that taking thalidomide significantly reduced the cough and improved quality of life.

Results of their study are scheduled to be published in the on Sept. 18 in an article titled "Thalidomide for the Treatment of Cough in Idiopathic ."

IPF is a progressive, fatal disorder that causes the lungs to become stiff and scarred, preventing oxygen from leaving the lungs to go to the rest of the body. The cause is unknown. Up to 80 percent of people with IPF have a dry, nagging cough, for which no effective treatment is available.

Thalidomide is a potent anti- that was used to treat and aid sleep in the 1950s. It was taken off the market in 1961 after it was shown to cause severe birth defects when women took the drug during pregnancy. Today, thalidomide is prescribed with strict controls to treat several diseases, including and . It had not been studied for people with lung disease before.

"We performed a randomized, double-blind, placebo- of thalidomide in patients with IPF to determine its effectiveness in suppressing cough," says lead author Maureen R. Horton, M.D., a pulmonary disease specialist and associate professor of medicine and at the Johns Hopkins University School of Medicine.

"We found that low-dose thalidomide significantly reduced the cough and also improved the patients' quality of life, as demonstrated on established questionnaires known as the Cough Quality of Life Questionnaire and the St. George's Respiratory Questionnaire," says Horton.

For the study, patients either took low-dose thalidomide pills or a placebo for three months. Then there was a two-week "wash out" period in which the patients took nothing, followed by another three months when those who had taken the thalidomide went on the placebo and those who had been given the placebo started taking thalidomide.

Neither the patients nor the researchers knew which group the individuals were in.

Twenty patients completed both arms of the study, 15 men and five women. All were over age 50 and the mean age was 67.

Horton says patients often noticed the difference within two weeks of taking the thalidomide. When they stopped the drug, their cough came back. "At the end of the study, all of the participants said they wanted to continue taking the medicine because their cough had improved."

On average, the patients reported that the frequency of their coughing decreased about 63 percent while they were taking thalidomide, and their respiratory-specific quality of life, such as the ability to do daily activities, improved about 20 percent. They also reported that the aspects of their life impacted by their cough also improved while they were on the drug.

"The constant cough caused by the disease can affect the quality of life in many ways," says Horton. "Some no longer go to church or to social gatherings because people think they are infectious. Other patients may have more pronounced urinary incontinence due to the cough, for example, so it has wide-ranging effects."

Side effects, such as constipation, dizziness and malaise were reported by 74 percent of the participants while they were taking thalidomide, and by 22 percent of those who were on a placebo.

Horton says the idea of testing thalidomide for cough among IPF patients came about because the drug is known to have a powerful effect on decreasing inflammation. Horton and her colleagues conducted a previous smaller study to see if would help treat the IPF disease itself, and while the results of that research were not conclusive, they noticed that the had significant cough relief.

About 80,000 people in the United States have IPF, although it may be underdiagnosed. The risk increases with age. Treatments for the symptoms include oxygen therapy and pulmonary rehabilitation, but there is no for the constant , which is a hallmark of IPF. Life expectancy after diagnosis is only about three to five years. The only cure is a lung transplant.

"Although the results were significant, this was a small study and we believe that a larger trial is warranted to confirm these promising results and also assess the drug's impact on the disease itself," says Horton. "We have some hope that this therapy may be able to slow the progression of IPF, but that would have to be tested in a larger study."

Explore further: Cough may warn of danger for patients with lung-scarring disease

Related Stories

Cough may warn of danger for patients with lung-scarring disease

October 18, 2011
A new analysis has found that coughing may signal trouble for patients with the lung-scarring disease known as idiopathic pulmonary fibrosis. The study, published in the journal Respirology, found that patients with the condition ...

Widely used drug could offer substantial relief to people with chronic cough

August 27, 2012
New research published Online First in the Lancet is the first to show that gabapentin, a drug widely used to treat pain and seizures, substantially reduces the frequency and severity of coughing and other symptoms associated ...

Recommended for you

Two Group A Streptococcus genes linked to 'flesh-eating' bacterial infections

September 22, 2017
Group A Streptococcus bacteria cause a variety of illnesses that range from mild nuisances like strep throat to life-threatening conditions including pneumonia, toxic shock syndrome and the flesh-eating disease formally known ...

Ecosystem approach makes urinary tract infection more treatable

September 22, 2017
The biological term 'ecosystem' is not usually associated with urinary tract infections, but this should change according to Wageningen scientists.

Residents: Frontline defenders against antibiotic resistance?

September 22, 2017
Antibiotic resistance continues to grow around the world, with sometimes disastrous results. Some strains of bacteria no longer respond to any currently available antibiotic, making death by infections that were once easily ...

Investigators may unlock mystery of how staph cells dodge the body's immune system

September 21, 2017
For years, medical investigators have tried and failed to develop vaccines for a type of staph bacteria associated with the deadly superbug MRSA. But a new study by Cedars-Sinai investigators shows how staph cells evade the ...

Superbug's spread to Vietnam threatens malaria control

September 21, 2017
A highly drug resistant malaria 'superbug' from western Cambodia is now present in southern Vietnam, leading to alarming failure rates for dihydroartemisinin (DHA)-piperaquine—Vietnam's national first-line malaria treatment, ...

Individualized diets for irritable bowel syndrome better than placebo

September 21, 2017
Patients with irritable bowel syndrome who follow individualized diets based on food sensitivity testing experience fewer symptoms, say Yale researchers. Their study is among the first to provide scientific evidence for this ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.