Nalbuphine ER May Reduce Chronic Cough in IPF Patients
A phase 2b trial shows this treatment could help adults with IPF manage persistent coughing symptoms.
Updated on Oct. 29, 2026 in Asthma
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A phase 2b trial found that the experimental medication nalbuphine ER significantly reduced chronic cough frequency in patients with idiopathic pulmonary fibrosis (IPF). Currently, there are no FDA-approved therapies specifically for chronic cough in people living with this condition.
Why it matters
Chronic cough is a persistent challenge for those with IPF, and this new drug candidate offers a potential future treatment option as researchers move into larger clinical trials. Finding an effective way to manage this symptom is essential, as there is currently no approved medical standard of care for it in the United States.
In the CORAL trial of 165 patients with IPF, those treated with nalbuphine ER showed significant reductions in cough frequency compared to placebo by week 6. While these results are promising, the long-term safety profile and clinical durability remain under investigation.
The players
CHEST
A professional society for clinicians focused on chest medicine, pulmonary, critical care, and sleep medicine.
The details
Nalbuphine ER functions by modulating the cough reflex arc as a mixed kappa opioid receptor agonist and a mu opioid receptor antagonist. By targeting these receptors, the medication aims to suppress the persistent urge to cough common in IPF. Researchers selected a 54-mg dosage for upcoming phase 3 testing after observing that the highest dose did not provide a clear advantage in patient-reported outcomes compared to the 54-mg option.
Timeline
Week 1: Patient-reported cough severity showed improvement versus placebo.
Week 2: E-RS:IPF cough subscale showed relative improvement.
Week 6: Primary analysis measured objective cough frequency changes.
October 18-21, 2026: Trial data presented at CHEST 2026 meeting.
Week 24: Primary endpoint for upcoming phase 3 trial.
Health Landscape
The CORAL phase 2b trial marks a significant step forward in addressing the lack of FDA-approved therapies for chronic cough in IPF patients. This research updates the treatment landscape by establishing the clinical basis for upcoming late-stage testing of nalbuphine ER.
If you are managing idiopathic pulmonary fibrosis and struggle with a chronic cough, this progress represents a potential future treatment avenue worth monitoring. It is a topic to discuss with your pulmonologist, who can provide context on upcoming clinical trials or emerging evidence in the field.
The takeaway
While currently in the research phase, the trial highlights that chronic cough in IPF may eventually be manageable through receptor-targeted therapy. Patients should stay informed about their options and consult with their physician regarding how new clinical findings might impact their long-term care plans.
What happens next
A phase 3 clinical trial is currently underway, with participants expected to remain on treatment for 52 weeks to collect comprehensive safety data and evaluate cough counts at week 24.
Further reading
To learn more about managing lung health and chronic conditions, visit our Asthma section.
Source note: This article includes information reported by Hcplive.
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