Mepolizumab for the treatment of refractory chronic cough with eosinophilic airways disease (MUCOSA): a randomized, double-blind, placebo-controlled trial
Bibliographic record
Abstract
Background Patients with refractory chronic cough(RCC) with underlying asthma or non-asthmatic eosinophilic bronchitis(NAEB) often have persistent coughing despite inhaled or oral corticosteroid. Eosinophils have been shown to co-localise with sensory airway nerves and are associated with increased neuronal sensitivity. We evaluated whether mepolizumab reduces coughs in RCC with persistent eosinophilic airways disease. Methods A randomized, double-blind, placebo-controlled, parallel-group trial of patients with RCC and sputum eosinophilia ≥2% with either asthma or NAEB was conducted. Patients underwent 1:1 randomization to receive 4 doses of mepolizumab (100mg) or placebo every 4 weeks. The primary endpoint was the change from baseline in 24-hour cough frequency(c/hr) at week 14 using the VitaloJAK cough monitor. Secondary endpoints included change in the Leicester Cough Questionnaire (LCQ) and Cough Severity Visual Analogue Scale(VAS). Results 46 participants were screened and 30 met eligibility (mean age (S.D) 65.8(11.6), 56.7% female, %sputum eosinophils 3.7%(2.4), 19 asthmatics, 11 NAEB). Treatment with mepolizumab did not reduce 24-hour cough frequency compared to placebo at week 14 (18.6% higher, 95% C.I -23% to 82%, P=0.44). There was no difference in LCQ or VAS scores. Mepolizumab showed a significant reduction in sputum and blood eosinophils. Conclusion In this patient population, mepolizumab did not objectively or subjectively improve cough. Targeting eosinophils might not improve cough and an alternate mechanism might be driving cough in this RCC population. Funded by an investigator-initiated grant from GlaxoSmithKline.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".