An overview of refractory chronic cough (RCC), a persistent cough lasting over eight weeks despite treatment of underlying conditions. They explain that RCC stems from cough hypersensitivity syndrome, where sensory nerves become overly sensitive, often due to viral infections, and are activated by ATP binding to P2X3 receptors. The diagnostic pathway for RCC is one of exclusion, involving ruling out common causes like asthma or GERD over several months, as no single test exists. Current treatments include speech pathology and off-label neuromodulators, which have limited efficacy and significant side effects. However, emerging P2X3 antagonists like gefapixant and camlipixant offer targeted therapy by blocking these receptors, addressing the underlying mechanism and representing a substantial commercial opportunity in a market with significant unmet patient needs.

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