Promising results in King’s trial to reduce urinary incontinence in women with chronic cough

16 June 2025 - Over half the trial cohort experienced a reduction in symptoms

A clinical trial to determine the efficacy of a drug to reduce cough-induced stress urinary incontinence in women has shown promising results.

As outlined in a research paper published in The Lancet Respiratory Medicine, Gefapixant was shown to be effective among over half of trial participants, with 52.8 per cent reporting a reduction in symptoms after taking the drug, compared with 41 per cent in the placebo group.

Gefapixant, which is taken orally, works by blocking receptors in the sensory nerves that control coughing and reduces their hypersensitivity.

Urinary incontinence is defined as an involuntary loss of urine on effort, physical exertion, sneezing, or coughing.

Individuals with chronic cough experience repetitive daily increases in intra-abdominal pressure, which has been shown to be associated with pelvic organ dysfunction, including stress urinary incontinence in women, as reported by two-thirds of those attending cough clinics.

Professor Surinder Birring, who leads the specialist cough clinic at King’s College Hospital, was the Chief Investigator of the trial conducted in 12 countries. He said, “Urinary incontinence in patients with chronic cough is often a silent and unreported problem due to embarrassment about the condition.

“However, clinicians are encouraged to ask patients about this associated condition so that support and treatment options – both surgical and non-surgical – can be offered.

“Urinary incontinence can have a profound impact on quality of life, with patients reporting behaviour modification, such as dressing differently and drinking less, as well as embarrassment and depression as a direct result of the condition. The results of this trial is a step forward in offering an effective treatment for the women affected due to chronic cough.”

Sixty-two-year-old King’s patient, Pauline, from Kent, who did not take part in the trial, developed a chronic cough and cough-induced stress urinary incontinence in August 2023 after contracting COVID-19. As a result, Pauline’s life has changed significantly. She has modified the way she lives her life and has been signed off work for the last nine months due to periods of extreme coughing and the need to use the toilet.

She said, “I work on a reception desk and have bouts of coughing – and therefore leaking. It’s not as though you can just get up and go to the toilet when you’re talking to a customer. Initially, I tried to work through it but I had to give in because I just couldn’t cope.

“It’s a very embarrassing condition. It has impacted all aspects of my life from work, to socialising and relationships. Going out now seems like such an effort, and sometimes it’s just not worth it. I don’t think people realise how debilitating this condition is.

“The results of this trial gives hope to patients like me. If offered the trial drug, I would take it in the hope I can get back to the life I used to live.”