Treatments for subacute cough in primary care: systematic review and meta-analyses of randomised clinical trials.
- Speich B Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
- Thomer A Centre for Primary Health Care, University of Basel, Basel, Switzerland.
- Aghlmandi S Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
- Ewald H Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, and Swiss Tropical and Public Health Institute, and University Medical Library, University of Basel, Basel, Switzerland.
- Zeller A Centre for Primary Health Care, University of Basel, Basel, Switzerland.
- Hemkens LG Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
- 2018-09-12
Published in:
- The British journal of general practice : the journal of the Royal College of General Practitioners. - 2018
cough
cough score
disease progression
subacute
treatment
Acute Disease
Administration, Inhalation
Adrenal Cortex Hormones
Anti-Asthmatic Agents
Antitussive Agents
Cough
Humans
Primary Health Care
Randomized Controlled Trials as Topic
Treatment Outcome
English
BACKGROUND
Subacute cough following a non-specific viral infection lasting 3-8 weeks is common. However, despite many treatment options there are no systematic reviews evaluating these.
AIM
To provide a systematic overview of treatment options and outcomes evaluated in randomised clinical trials (RCTs).
DESIGN AND SETTING
Systematic review and meta-analyses assessing the overall effects of any treatment for subacute cough.
METHOD
The authors systematically searched PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (last search March 2017) for RCTs in adult patients with subacute cough. The authors considered trials evaluating any outcome of any drug or non-drug treatments, apart from traditional Chinese and Asian medicines. They combined treatment effects on cough-related outcomes in random effects meta-analyses.
RESULTS
Six eligible RCTs including 724 patients were identified. These assessed montelukast, salbutamol plus ipratropium bromide, gelatine, fluticasone propionate, budesonide, and nociception opioid 1 receptor agonist and codeine. Five studies reported effects on various cough severity scores at various timepoints. No treatment option was associated with a clear benefit on cough recovery or other patient-relevant outcomes in any of the studies or in meta-analyses for cough outcomes at 14 days and 28 days. Reported adverse events were rather mild and reported for 14% of patients across all treatments.
CONCLUSION
Evidence on treatment options for subacute cough is weak. There is no treatment showing clear patient-relevant benefits in clinical trials.
Subacute cough following a non-specific viral infection lasting 3-8 weeks is common. However, despite many treatment options there are no systematic reviews evaluating these.
AIM
To provide a systematic overview of treatment options and outcomes evaluated in randomised clinical trials (RCTs).
DESIGN AND SETTING
Systematic review and meta-analyses assessing the overall effects of any treatment for subacute cough.
METHOD
The authors systematically searched PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (last search March 2017) for RCTs in adult patients with subacute cough. The authors considered trials evaluating any outcome of any drug or non-drug treatments, apart from traditional Chinese and Asian medicines. They combined treatment effects on cough-related outcomes in random effects meta-analyses.
RESULTS
Six eligible RCTs including 724 patients were identified. These assessed montelukast, salbutamol plus ipratropium bromide, gelatine, fluticasone propionate, budesonide, and nociception opioid 1 receptor agonist and codeine. Five studies reported effects on various cough severity scores at various timepoints. No treatment option was associated with a clear benefit on cough recovery or other patient-relevant outcomes in any of the studies or in meta-analyses for cough outcomes at 14 days and 28 days. Reported adverse events were rather mild and reported for 14% of patients across all treatments.
CONCLUSION
Evidence on treatment options for subacute cough is weak. There is no treatment showing clear patient-relevant benefits in clinical trials.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.3399/bjgp18X698885
- PMID 30201828
- Persistent URL
- https://sonar.ch/global/documents/232397
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