Imran Satia

McMaster University | McMaster · Division of Respirology

Importance: Gefapixant represents an emerging therapy for patients with refractory or unexplained chronic cough. Objective: To evaluate the efficacy and tolerability of gefapixant for the treatment of adults with refractory or unexplained chronic cough. Data sources: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of S...

Background: The single breath diffusion capacity for carbon monoxide (DLCO) captures several aspects of the role of the lung in meeting the metabolic demands of the body. The magnitude of the independent contributors to the DLCO is unknown. The aim of this study was to investigate the factors that independently contribute to the DLCO. Objectives:...

Introduction: Chronic cough is a debilitating condition that is among the most common reasons for seeking medical attention yet remains challenging to manage. Identifying an underlying respiratory, nasal or upper gastrointestinal disease triggering cough is the first step in assessment, but once this has been ruled out or adequately treated, many...

Introduction Educational programs on chronic cough may improve patient care, but little is known about how Canadian physicians manage this common debilitating condition. We aimed to investigate Canadian physicians’ perceptions, attitudes, and knowledge of chronic cough. Methods We administered a 10-min anonymous, online, cross-sectional survey to...

Background: Chronic cough is a common troublesome condition and accounts for a high burden on quality of life. Previous data investigating the mortality associated with chronic cough has been derived in patients with chronic bronchitis. No data exists on chronic dry cough. Therefore, we investigated if chronic dry and productive cough is independe...

Chronic cough is a debilitating condition affecting 10–12% of the general population and is one of the leading causes for referral to secondary care. Many conditions have been associated with chronic cough, including asthma, gastro-esophageal reflux disease and upper airways cough syndrome. Inflammatory airway conditions including cough variant ast...

In recent years our understanding of the neurophysiological basis of cough has increased substantially. In conjunction, concepts around the drivers of chronic coughing in patients have also significantly evolved. Increasingly it is recognised that dysregulation of the neuronal pathways mediating cough play an important role in certain phenotypes of...

Introduction Objective cough frequency is a key clinical endpoint but existing wearable monitors are limited to 24-h recordings. Albus Home uses contactless motion, acoustic and environmental sensors to monitor multiple metrics, including respiratory rate and cough without encroaching on patient lifestyle. The aim of this study was to evaluate meas...

Introduction In phase 3 trials (COUGH-1/COUGH-2), gefapixant 45 mg twice daily significantly reduced 24-h cough frequency vs placebo in refractory or unexplained chronic cough (RCC or UCC). Methods Here, the efficacy of gefapixant 45 mg vs placebo was evaluated across COUGH-1/COUGH-2 in predefined subgroups based on sex, region, age, cough duratio...

Background: Out of over 3 billion people exposed to household air pollution (HAP), approximately 4 million die prematurely, most from cardiorespiratory diseases. Although many recent studies have reported adverse effects of HAP on cardiovascular outcomes, the findings are inconsistent. Objectives: The primary aim of this systematic review is to...

Background : Current characterization of patients with refractory or unexplained chronic cough (RCC and UCC, respectively) primarily stems from relatively small clinical studies. Objective : To report the baseline medical history and clinical characteristics of individuals with RCC or UCC enrolled in COUGH-1 and COUGH-2, two large, global, phase 3...

Chronic Cough is a common troublesome condition, but risk factors for developing chronic cough are poorly understood. The aim of this study was to understand the relationship between mental health disorders, personality traits and chronic cough. The Canadian Longitudinal Study on Aging is a prospective, nationally generalizable, random sample of ad...

Objective Baclofen is a centrally acting γ-aminobutyric acid type B (GABA B ) receptor agonist which reduces gastro-oesophageal reflux and suppresses the cough reflex; however, central nervous system side-effects limit its use. Lesogaberan is a novel peripherally acting GABA B agonist, but its effects on refractory chronic cough are unknown. Desig...

Background: Cough symptom severity represents an important subjective end-point to assess the impact of therapies for patients with refractory or unexplained chronic cough (RCC/UCC). As existing instruments assessing the severity of cough are neither widely available nor tested for measurement properties, we aim to develop a new patient-reported o...

French speakers have a 4% lower incidence of chronic cough than English speakers in the CLSA, but English speakers from Quebec, Newfoundland and Labrador, and Nova Scotia also have a lower risk of developing chronic cough https://bit.ly/3qAd3Mf.

Although asthma is very common affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world that results in both over- and under-diagnosis. A task force (TF) was set up by the European Respiratory Society to systematically review the literature on the diagnostic accuracy of tests used to diagnose asthma...

BACKGROUND. Adenovirus-vectored (Ad-vectored) vaccines are typically administered via i.m. injection to humans and are incapable of inducing respiratory mucosal immunity. However, aerosol delivery of Ad-vectored vaccines remains poorly characterized, and its ability to induce mucosal immunity in humans is unknown. This phase Ib trial evaluated the...

Purpose Gastro-oesophageal reflux disease (GORD) is commonly thought to play an important role in chronic cough and patients are often empirically treated with acid suppression therapy. We sought to investigate the response rate to acid suppression treatment in patients with and without heartburn attending two specialist cough clinics. Methods A r...

The World Health Organization (WHO) estimates that around 3 billion people today are exposed to smoke from the household combustion of solid fuels. While the household use of solid fuels has decreased over the last few decades, it remains a leading modifiable risk factor for the global burden of disease. This systematic review analyzed the impact o...

Chronic cough, defined as cough lasting 8 weeks or longer, is a condition for which there is currently no licensed treatment. Chronic cough affects approximately 16% of Canadian adults between the age of 45 and 85 years and is often associated with physical, social, and psychological impairments. The purpose of this state-of-the-art review is to hi...

Background Beta blockers prolong life in patients with cardiovascular diseases. Negative chronotropic and inotropic effects carry the potential to adversely effect peripheral skeletal and airway smooth muscle contributing to further fatigue, dyspnea and exercise intolerance. Research questions Do beta-blockers reduce maximal power output (MPO), VO...

Background: Cough severity represents an important subjective endpoint in assessing the effectiveness of therapies for patients with chronic cough. Although cough-specific quality of life questionnaires exist, a widely available cough severity instrument with established measurement properties remains unavailable. Aims: To identify and summarise...

Background: Adenoviral (Ad)-vectored vaccines are typically administered via intramuscular injection to humans, but this route of delivery is unable to induce respiratory mucosal immunity which requires respiratory mucosal route of vaccination. However, inhaled aerosol delivery of Ad-vectored vaccines has remained poorly characterized and its abili...

Purpose: Gastro-oesophageal reflux disease (GORD) is commonly thought to play an important role in chronic cough and patients are often empirically treated with acid suppression therapy. We sought to investigate the response rate to acid suppression treatment in patients with and without heartburn attending two specialist cough clinics. Methods: A...

Background: Currently there are no effective licensed anti-tussive therapies. Understanding how the neuronal mechanisms mediating the cough reflex in animal models translate to humans is important for the development of effective therapies. Pre-clinical studies suggest that the activation of GABAB receptors in both the peripheral and central nervo...

Objective To investigate the relationship between breastfeeding and the development of pediatric asthma. Methods A systematic review and meta-analysis was conducted with MEDLINE, EMBASE, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children <18 years old with breastfeeding exposure reported w...

These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical e...

Blocking NMDA receptors with memantine in refractory chronic cough patients is poorly tolerated and demonstrates no improvement in cough https://bit.ly/3kgx2g1.

Background: Cough is a common troublesome symptom in asthma which is neuronally mediated. Limosilactobacillus reuteri DSM-17938 (L. reuteri DSM-17938) is a probiotic shown to be effective in pre-clinical models at suppressing neuronal responses to capsaicin, a transient receptor potential vanilloid agonist (TRPV1). Objective: Investigate the eff...

Background The effects of long-term cigarette smoke exposure on pulmonary physiology and how those effects lead to reduced exercise capacity are not well established. Methods We retrospectively analyzed the spirometry, single-breath gas transfer (DLCO), peripheral muscle strength, and maximum exercise capacity data in patients referred to McMaster...

Heightened capsaicin cough sensitivity is independently associated with poor asthma control in moderate-to-severe asthma patients https://bit.ly/3mkbLkI.

Background: Currently there are no effective licensed anti-tussive therapies. Understanding how the neuronal mechanisms mediating the cough reflex in animal models translate to humans is important for the development of effective therapies. Pre-clinical studies suggest that the activation of GABAB receptors in both the peripheral and central nervou...

Our report demonstrates that while there is no difference between anti-IL-5 therapies for absolute or percent change in weight or BMI between individual groups, there is a subgroup of patients who have a clinically significant increase in body weight despite a reduction in steroid burden and blood eosinophils. We validated our results using data fr...

The global prevalence of chronic cough(CC) is highly variable ranging from 2–18%. There is a lack of data on the prevalence and incidence of CC from the general population . The objective of this study was to investigate the prevalence and incidence of CC in a sample of Canadian adults, and how these influenced by age, sex, smoking, respiratory sym...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic since early 2020. The coronavirus disease 2019 (COVID-19) has already caused more than two million deaths worldwide and affected people's physical and mental health. COVID-19 patients with mild symptoms are generally required to self-isolate and monitor for symptoms...

Background The importance of age, sex and respiratory virus prevalence to Emergency Department (ED) visits and hospitalisations for respiratory tract infections (RTIs), asthma, and chronic obstructive pulmonary disease (COPD) in a whole population over time is not well established. Methods This study retrospectively analysed data for the daily ED...

Background Small for gestational age (SGA) is common among newborns in low‐income countries like Nepal and has higher immediate mortality and morbidities. Objectives To study the prevalence and prognostic factors of SGA babies in Western Nepal. Methods A cross‐sectional study (November 2016‐October 2017) was conducted in a tertiary care hospital...

Exercise-induced bronchoconstriction (EIBc) is a recognised response to exercise in asthmatic subjects and athletes but is less well understood in an unselected broad population. Exercise-induced bronchodilation (EIBd) has received even less attention. The objective of this study was to investigate the effects of age, sex, forced expiratory volume...

Background Refractory chronic cough (RCC) is a debilitating condition for which there are no licensed treatments. Lidocaine is a non-selective inhibitor of voltage gated sodium channels (VGSC) with potential anti-tussive effects, but randomized placebo-controlled studies evaluating its efficacy in RCC are lacking. Objective To investigate the effi...

The capacity to exercise is a major contributor to functional limitation and is accompanied by increased morbidity and mortality. What are the most important physiological contributors to exercise capacity? Cross-sectional data from consecutive patients referred to the McMaster University Medical Centre exercise laboratory for incremental cardiopul...

Background Asthma exacerbations increase in September coinciding with children returning to school. The aim of this study was to investigate whether this occurs 1) for COPD and respiratory tract infections (RTIs); 2) after school resumes in January and March; and 3) identify which viruses may be responsible. Methods Emergency department (ED) visit...

The pathophysiology of refractory chronic cough (RCC) is unclear. We hypothesised that endogenous inhibitory control mechanisms, such as those activated by noxiousstimuli inducing pain (conditioned pain modulation (CPM)), may be capable of inhibiting coughing and urge to cough evoked by inhaled capsaicin. Furthermore, these mechanisms may be impair...

Chronic cough affects approximately 10% of general population, is highest amongst people aged 50-60, and is twice as common in women than men. It is described to last 8 weeks or longer in adults and not treated effectively with most over-the-counter medications. This is a debilitating condition with physical, social, and psychological consequences....

Rationale: Cough is the archetypal airway neuronal reflex. Increased neuronal hypersensitivity has been shown in asthmatics to inhaled irritants such as capsaicin, a direct agonist of transient receptor potential vanilloid type-1(TRPV1), found mainly on C-fibres. However, there are other TRP channels on C-fibres and A-delta fibres sensitive to cha...

Rationale: The effort required to cycle and breathe intensify as power increases during incremental exercise. It is currently unclear how changes in FEV1 in the presence or absence of airflow limitation) impacts the intensity of dyspnea and leg effort. This is clinically important as the improvement in FEV1 is often the target for improving dyspne...

Objective The goal of asthma management is to achieve optimal asthma control, defined by absence of daytime symptoms, night time waking, reliever use, functional limitation and lung function stability, and to also reduce the future risks of asthma exacerbations, deterioration in lung function and medication's side effects. The most widely used main...

Background Findings from previous studies reporting on the associations between chronic obstructive pulmonary disease (COPD) and various dietary patterns have been inconsistent. This review aims to summarise the evidence on the strength of the association between dietary patterns and the prevalence and incidence of COPD. Methods We conducted a com...