{"id":516,"date":"2026-01-28T12:47:43","date_gmt":"2026-01-28T12:47:43","guid":{"rendered":"https:\/\/blogs.imperial.ac.uk\/nhli\/?p=516"},"modified":"2026-02-12T12:57:37","modified_gmt":"2026-02-12T12:57:37","slug":"trialling-nalbuphine-er-as-a-treatment-for-idiopathic-pulmonary-fibrosis-an-interview-with-professor-philip-molyneaux","status":"publish","type":"post","link":"https:\/\/blogs.imperial.ac.uk\/nhli\/2026\/01\/28\/trialling-nalbuphine-er-as-a-treatment-for-idiopathic-pulmonary-fibrosis-an-interview-with-professor-philip-molyneaux\/","title":{"rendered":"Trialling Nalbuphine ER as a treatment for Cough in Idiopathic Pulmonary Fibrosis: An interview with Professor Philip Molyneaux"},"content":{"rendered":"

“Finding a specific treatment for chronic cough in IPF could have a huge impact on patients\u2019 lives.”<\/span><\/h2>\n

\"\"<\/p>\n

Philip Molyneaux is Professor of Interstitial Lung Disease at the National Heart and Lung Institute, the Asthma + Lung UK Chair of Respiratory Research,\u00a0<\/span>and Direct<\/span>or\u00a0of the NIHR Clinical Research Facility at the Royal Brompton Hospital, where he is also a Consultant in Interstitial Lung Disease.<\/span><\/p>\n

We spoke to Professor Molyneaux about his ongoing research into the treatment of cough in Idiopathic Pulmonary Fibrosis (IPF), after the <\/span>conclusion of a successful phase two trial.<\/span><\/p>\n

\n

Can you summarise your research and what you found in plain language?<\/b><\/em><\/p>\n

We have been trialling a new drug,\u00a0Nalbuphine ER, for the treatment of cough in patients living with Idiopathic\u00a0Pulmonary Fibrosis (IPF). IPF is a scarring lung disease\u00a0and around 80% of\u00a0people\u00a0with the condition\u00a0suffer with\u00a0chronic\u00a0cough. This worsens their quality of life and currently\u00a0there are no\u00a0treatments available.<\/p>\n

We recently ran a phase two clinical trial, in which 165 IPF patients with chronic cough were either given one of three different strength doses of Nalbuphine ER, or a placebo, for six weeks. We recorded the number of coughs-per-hour in each patient over the first and last 24 hours of the study and found that the cough count dropped across all three doses of the drug compared to the placebo, with the strongest dose proving to be the most effective. We also asked patients about their own perception of the rate and severity of their cough; those taking the two stronger doses of the drug noticed a significant decrease in their symptoms.<\/p>\n

“Our research shows that the mechanisms we are targeting improve cough, helping us to gain a deeper understanding of IPF and its symptoms.”<\/strong><\/h3>\n

Why is this research important? What problem does it address?<\/b>\u00a0<\/em><\/p>\n

Finding a specific treatment for chronic cough\u00a0in\u00a0IPF\u00a0could have\u00a0a huge impact\u00a0on patients\u2019 lives.\u00a0Current treatments are simply borrowed\u00a0cough treatments for\u00a0other respiratory\u00a0conditions.\u00a0They are\u00a0often ineffective and\u00a0trialling them\u00a0wastes\u00a0time\u00a0\u2013 something\u00a0which is\u00a0in short supply when it comes to IPF, which has a life expectancy of only three and a half years.<\/span>\u00a0<\/span><\/p>\n

Previous\u00a0studies have shown that cough has a detrimental effect on the lives of\u00a0patients\u00a0with IPF. It can contribute to anxiety\u00a0and depression, as well as causing incontinence and even blackouts. Plus, in the aftermath of the Covid-19 pandemic, coughing has been\u00a0socially stigmatised. All these things can threaten IPF patients\u2019 quality of life,\u00a0which is why finding a disease-specific treatment is so important.<\/span>\u00a0<\/span><\/p>\n

What are the most significant findings or outcomes?<\/b>\u00a0<\/em><\/p>\n

Our trial,\u00a0which recruited\u00a0at the Royal Brompton Hospital\u2019s\u00a0Cardiorespiratory\u00a0clinical\u00a0research facility,\u00a0is\u00a0the first positive\u00a0head-to-head\u00a0placebo-controlled study into IPF cough. It\u00a0shows\u00a0that there is\u00a0potentially\u00a0a treatment which could improve IPF patients\u2019 quality of life, as opposed to simply slowing down the progression of the disease.\u00a0We hope that Nalbuphine ER could become a useful treatment for IPF cough, but more research is needed to confirm this, and to check the drug\u2019s long-term safety.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>\n

How might this research\u00a0impact\u00a0policy or the public?<\/b>\u00a0<\/em><\/p>\n

Policy, as all medical researchers will know, must change when a new drug is approved. Nalbuphine ER is a drug that\u00a0has been used\u00a0previously,\u00a0as an injectable post-operative painkiller;\u00a0our version is in a tablet format, with a different\u00a0indication. If Nalbuphine ER is approved as a treatment for IPF cough after\u00a0a\u00a0phase three trial, treatment guidelines would hopefully change\u00a0rapidly as there are no other options.\u00a0<\/span>\u00a0<\/span><\/p>\n

When it comes to the public, cough takes up a lot of healthcare resources, including some people might not expect, such as occupational and speech and language therapists. If IPF patients\u2019 coughs improve, these finite resources will be freed up for others who may need support.<\/span>\u00a0<\/span><\/p>\n

How do these findings advance knowledge or practice in your field?<\/b>\u00a0<\/em><\/p>\n

Our research shows that the mechanisms we are targeting improve cough, helping us to gain a deeper understanding of IPF and its symptoms. While this is crucial as it gives us clues into how IPF cough works and how it can be best treated, there are still many questions to ask.<\/span>\u00a0<\/span><\/p>\n

We are unsure whether Nalbuphine ER will work for\u00a0<\/span>all<\/span><\/i>\u00a0patients with IPF and cough. We\u00a0don\u2019t\u00a0know if reducing cough can slow disease progression, nor do we know why some IPF patients cough more than others;\u00a0perhaps this\u00a0knowledge will arise tangentially from the work we are doing. Moreover, we are currently only looking at\u00a0<\/span>idiopathic<\/span><\/i>\u00a0pulmonary fibrosis, so there is a possibility that Nalbuphine ER may work for those living with non-idiopathic or familial pulmonary fibrosis too.<\/span>\u00a0<\/span><\/p>\n

Does\u00a0your work\u00a0tie into any wider\u00a0research?<\/b>\u00a0<\/em><\/p>\n

There is so much great research happening around the impact of cough and whether it is the same across all fibrotic lung diseases. From what we can tell, it\u00a0seems to be\u00a0very similar\u00a0to\u00a0IPF, which suggests that Nalbuphine ER could be used to treat cough in a range of respiratory conditions.<\/span>\u00a0<\/span><\/p>\n

We would also like to look at whether cough comes from the brain, the nerves, or the lungs by conducting MRI scans to observe what happens in the brain when someone is coughing and examining lung volume changes in people with chronic cough.<\/span>\u00a0<\/span><\/p>\n

What are the next steps?<\/b>\u00a0<\/em><\/p>\n

The next step is a phase three trial, looking at a larger patient population for a longer duration\u00a0<\/span>to ensure the benefit is sustained<\/span>. We are hoping to\u00a0start\u00a0this\u00a0study\u00a0later this year.\u00a0<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

“Finding a specific treatment for chronic cough in IPF could have a huge impact on patients\u2019 lives.” Philip Molyneaux is Professor of Interstitial Lung Disease at the National Heart and Lung Institute, the Asthma + Lung UK Chair of Respiratory Research,\u00a0and Director\u00a0of the NIHR Clinical Research Facility at the Royal Brompton Hospital, where he is […]<\/p>\n","protected":false},"author":1950,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21,20],"tags":[12],"class_list":["post-516","post","type-post","status-publish","format-standard","hentry","category-research","category-staff-profile","tag-cardiovascular-and-respiratory-healthcare"],"yoast_head":"\nTrialling Nalbuphine ER as a treatment for Cough in Idiopathic Pulmonary Fibrosis: An interview with Professor Philip Molyneaux - National Heart and Lung Institute<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.imperial.ac.uk\/nhli\/2026\/01\/28\/trialling-nalbuphine-er-as-a-treatment-for-idiopathic-pulmonary-fibrosis-an-interview-with-professor-philip-molyneaux\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trialling Nalbuphine ER as a treatment for Cough in Idiopathic Pulmonary Fibrosis: An interview with Professor Philip Molyneaux - 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