(0824) Otolaryngologists in the Era of P2X3 Receptor Antagonists: A Critical Review of the Literature

Introduction: Despite a growing body of literature surrounding this new class of medication and its efficacy in treating chronic cough, there are few publications in the otolaryngologic literature surrounding P2X3 inhibitors. This article seeks to provide a state-of-the-art review of P2X3 inhibitors for the practicing otolaryngologist.

Methods: We conducted a comprehensive literature search to identify relevant articles from June 2000 up to September 2023, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched the following databases: PubMed, Google Scholar, Web of Science, and Embase, using the following terms “chronic cough and P2X3 antagonist”, “treatment of chronic cough”, and “otolaryngology and P2X3 antagonist.”

Results: Our final review included 52 publications. Most publications were review articles, 29/52, discussing the potential of this emerging therapy. Clinical trials were the next most common type of publication on this emerging treatment with 22 out of the 52 articles. Only one of the publications included was published in an otolaryngologic journal. Most of the articles focused on the P2X3 antagonist gefapixant; however, other potential medications of this class discussed included BLU-5937, eliapixant, sivopixant, and filapixant. In these articles, it was observed that while there may be certain side effects, mostly taste alteration, gefapixant is generally regarded as a safe and efficacious treatment for RCC/UCC.

Conclusions: Here, we discuss the emergence of a new antitussive class of medications, called P2X3 receptor antagonists and review the growing body of literature regarding its efficacy in treating chronic cough. Despite the paucity in otolaryngologic publications surrounding this emerging treatment, our review highlights early evidence for the efficacy of this class of medications in treating chronic cough. We argue for greater awareness of this class of medication among otolaryngologists and further research into this emerging treatment’s effect on the larynx.