Corticosteroids for the common cold

Gail Hayward, Matthew J. Thompson, Rafael Perera, Chris B. Del Mar, Paul P. Glasziou, Carl J. Heneghan

Research output: Contribution to journalReview articleResearchpeer-review

11 Citations (Scopus)

Abstract

The common cold is a frequent illness, which, although benign and self-limiting, results in many consultations to primary care and considerable loss of school or work days. Current symptomatic treatments have limited benefit. Corticosteroids are an effective treatment in other upper respiratory tract infections and their anti-inflammatory effects may also be beneficial in the common cold. To compare corticosteroids versus usual care for the common cold on clinical response rates in children and adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2012, Issue 5 which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects (DARE) 2012, Issue 4 and the NHS Health Economics Database 2012, Issue 5; MEDLINE (1948 to May week 2, 2012) and EMBASE (January 2010 to May 2012). Randomised, double-blind, controlled trials comparing corticosteroids to placebo or to standard clinical management. Two review authors independently extracted data and assessed trial quality. We were unable to perform meta-analysis and instead analysed results using narrative description of the available evidence. We included two trials (253 participants). Both compared intranasal corticosteroids to placebo; no trials studied oral corticosteroids. No benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. In one trial of 54 participants, the number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (P = 0.72). A second trial of 199 participants reported no significant differences in duration of symptoms. There were no differences reported in terms of: adverse events; complications (one case of sinusitis, one case of acute otitis media, both in corticosteroid groups); presence of rhinovirus in nasal aspirates; or treatment for secondary infections. Neither trial reported our primary outcome measure of percentage of participants with resolution at different time points. A lack of comparable outcome measures meant we were unable to combine the data. Current evidence does not support the use of intranasal corticosteroids for symptomatic relief from the common cold. However, there were only two trials and limited statistical power. Further large randomised placebo-controlled trials in adults and children are required to answer this question.

Original languageEnglish
Article numberCD008116
JournalCochrane Database of Systematic Reviews
Volume2012
Issue number8
DOIs
Publication statusPublished - 15 Aug 2012

Fingerprint

Common Cold
Adrenal Cortex Hormones
Placebos
Respiratory Tract Infections
Outcome Assessment (Health Care)
Databases
Rhinovirus
Sinusitis
Otitis Media
Coinfection
Nose
MEDLINE
Meta-Analysis
Primary Health Care
Anti-Inflammatory Agents
Therapeutics
Referral and Consultation
Randomized Controlled Trials
Economics

Cite this

Hayward, Gail ; Thompson, Matthew J. ; Perera, Rafael ; Del Mar, Chris B. ; Glasziou, Paul P. ; Heneghan, Carl J. / Corticosteroids for the common cold. In: Cochrane Database of Systematic Reviews. 2012 ; Vol. 2012, No. 8.
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Corticosteroids for the common cold. / Hayward, Gail; Thompson, Matthew J.; Perera, Rafael; Del Mar, Chris B.; Glasziou, Paul P.; Heneghan, Carl J.

In: Cochrane Database of Systematic Reviews, Vol. 2012, No. 8, CD008116, 15.08.2012.

Research output: Contribution to journalReview articleResearchpeer-review

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AU - Hayward, Gail

AU - Thompson, Matthew J.

AU - Perera, Rafael

AU - Del Mar, Chris B.

AU - Glasziou, Paul P.

AU - Heneghan, Carl J.

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AB - The common cold is a frequent illness, which, although benign and self-limiting, results in many consultations to primary care and considerable loss of school or work days. Current symptomatic treatments have limited benefit. Corticosteroids are an effective treatment in other upper respiratory tract infections and their anti-inflammatory effects may also be beneficial in the common cold. To compare corticosteroids versus usual care for the common cold on clinical response rates in children and adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2012, Issue 5 which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects (DARE) 2012, Issue 4 and the NHS Health Economics Database 2012, Issue 5; MEDLINE (1948 to May week 2, 2012) and EMBASE (January 2010 to May 2012). Randomised, double-blind, controlled trials comparing corticosteroids to placebo or to standard clinical management. Two review authors independently extracted data and assessed trial quality. We were unable to perform meta-analysis and instead analysed results using narrative description of the available evidence. We included two trials (253 participants). Both compared intranasal corticosteroids to placebo; no trials studied oral corticosteroids. No benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. In one trial of 54 participants, the number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (P = 0.72). A second trial of 199 participants reported no significant differences in duration of symptoms. There were no differences reported in terms of: adverse events; complications (one case of sinusitis, one case of acute otitis media, both in corticosteroid groups); presence of rhinovirus in nasal aspirates; or treatment for secondary infections. Neither trial reported our primary outcome measure of percentage of participants with resolution at different time points. A lack of comparable outcome measures meant we were unable to combine the data. Current evidence does not support the use of intranasal corticosteroids for symptomatic relief from the common cold. However, there were only two trials and limited statistical power. Further large randomised placebo-controlled trials in adults and children are required to answer this question.

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