The Effect of Aspirin on Converting Enzyme Inhibitors-Induced Coughs: A Double -Blind Clinical Trial

BACKGROUND- DRY COUGHS ARE THE MOST COMMON ADVERSE EFFECT AND LIMITING FACTOR OF ALL ANGIOTENSIN CONVERTING-ENZYME INHIBITORS (ACEI). PROSTAGLANDINS HAVE BEEN PINPOINTED AS PLAYING AN IMPORTANT ROLE IN THE GENESIS OF THIS PROBLEM.THIS DOUBLE BLIND CLINICAL TRIAL WAS DESINGED TO COMPARE THE EFFICACY OF 500 MILIGRAM(MG) ASPIRIN VERSUS PLACEBO IN CONTROLLING ACEI-INDUCED COUGHS. METHODS-THE SUBJECTS WERE 32 PATIENTS, WHO HAD DEVELOPED ACEI- INDUCED COUGHS.THEY WERE RANDOMIZED TO A DAILY DOSE OF 500 MG ASPIRIN OR PLACEBO FOR A TREATMENT PERIOD OF 4 WEEKS.THE MEANS OF COUGH SEVERITY BEFORE AND EACH WEEK FOR 4 WEEKS WERE COMPARED IN THE TWO GROUPS. RESULTS- MEANS OF COUGH SEVERITY IN THE ASPIRIN AND PLACEBO GROUPS BEFORE AND AT THE END OF THE FIRST WEEK OF TREATMENT DID NOT SHOW ANY SIGNIFICANT DIFFERENCE. AFTER THE SECOND, THIRD AND FOURTH WEEKS, THE COUGH SEVERITY SCORE WAS SIGNIFICANTLY REDUCED IN THE ASPIRIN GROUP (P<0.001). Conclusion-500mg aspirin once daily can suppress or abolish ACEI-induced coughs, and this finding proposes alternative therapeutic approaches for ACEI-related coughs