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Intranasal ipratropium bromide for the common cold.
Cochrane Database Syst Rev 2013; (6):CD008231CD

Abstract

BACKGROUND

The common cold is one of the most common illnesses in humans and constitutes an economic burden both in terms of productivity and expenditure for treatment. There is no proven cure for the common cold and symptomatic relief is the mainstay of treatment. The use of intranasal ipratropium bromide (IB) has been addressed in several studies and might prove an effective treatment for the common cold.

OBJECTIVES

To determine the effect of IB versus placebo or no treatment on severity of rhinorrhoea and nasal congestion in children and adults with the common cold. Subjective overall improvement was another primary outcome and side effects (for example, dry mucous membranes, epistaxis and systemic anticholinergic effects) were reported as a secondary outcome.

SEARCH METHODS

In this updated review we searched CENTRAL 2013, Issue 3, MEDLINE (1950 to March week 4, 2013), MEDLINE in-process and other non-indexed citations (8 April 2013), EMBASE (1974 to April 2013), AMED (1985 to April 2013), Biosis (1974 to February 2011) and LILACS (1985 to April 2013).

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing IB to placebo or no treatment in children and adults with the common cold.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data and assessed trial quality. We used a standardised form to extract relevant data and we contacted trial authors for additional information.

MAIN RESULTS

Seven trials with a total of 2144 participants were included. Four studies (1959 participants) addressed subjective change in severity of rhinorrhoea. All studies were consistent in reporting statistically significant changes in favour of IB. Nasal congestion was reported in four studies and was found to have no significant change between the two groups. Two studies found a positive response in the IB group for the global assessment of overall improvement. Side effects were more frequent in the IB group, odds ratio (OR) 2.09 (95% confidence interval (CI) 1.40 to 3.11). Commonly encountered side effects included nasal dryness, blood tinged mucus and epistaxis. The overall risk of bias in the included studies was moderate.

AUTHORS' CONCLUSIONS

For people with the common cold, the existing evidence, which has some limitations, suggests that IB is likely to be effective in ameliorating rhinorrhoea. IB had no effect on nasal congestion and its use was associated with more side effects compared to placebo or no treatment although these appeared to be well tolerated and self limiting. There is a need for larger, high-quality trials to determine the effectiveness of IB in relieving common cold symptoms.

Authors+Show Affiliations

Department of Medicine, University of Alberta, Edmonton, Canada. Zaina.albalawi@ualberta.ca.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

23784858

Citation

AlBalawi, Zaina H., et al. "Intranasal Ipratropium Bromide for the Common Cold." The Cochrane Database of Systematic Reviews, 2013, p. CD008231.
AlBalawi ZH, Othman SS, Alfaleh K. Intranasal ipratropium bromide for the common cold. Cochrane Database Syst Rev. 2013.
AlBalawi, Z. H., Othman, S. S., & Alfaleh, K. (2013). Intranasal ipratropium bromide for the common cold. The Cochrane Database of Systematic Reviews, (6), p. CD008231. doi:10.1002/14651858.CD008231.pub3.
AlBalawi ZH, Othman SS, Alfaleh K. Intranasal Ipratropium Bromide for the Common Cold. Cochrane Database Syst Rev. 2013 Jun 19;(6)CD008231. PubMed PMID: 23784858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intranasal ipratropium bromide for the common cold. AU - AlBalawi,Zaina H, AU - Othman,Sahar S, AU - Alfaleh,Khalid, Y1 - 2013/06/19/ PY - 2013/6/21/entrez PY - 2013/6/21/pubmed PY - 2013/11/20/medline SP - CD008231 EP - CD008231 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 6 N2 - BACKGROUND: The common cold is one of the most common illnesses in humans and constitutes an economic burden both in terms of productivity and expenditure for treatment. There is no proven cure for the common cold and symptomatic relief is the mainstay of treatment. The use of intranasal ipratropium bromide (IB) has been addressed in several studies and might prove an effective treatment for the common cold. OBJECTIVES: To determine the effect of IB versus placebo or no treatment on severity of rhinorrhoea and nasal congestion in children and adults with the common cold. Subjective overall improvement was another primary outcome and side effects (for example, dry mucous membranes, epistaxis and systemic anticholinergic effects) were reported as a secondary outcome. SEARCH METHODS: In this updated review we searched CENTRAL 2013, Issue 3, MEDLINE (1950 to March week 4, 2013), MEDLINE in-process and other non-indexed citations (8 April 2013), EMBASE (1974 to April 2013), AMED (1985 to April 2013), Biosis (1974 to February 2011) and LILACS (1985 to April 2013). SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing IB to placebo or no treatment in children and adults with the common cold. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. We used a standardised form to extract relevant data and we contacted trial authors for additional information. MAIN RESULTS: Seven trials with a total of 2144 participants were included. Four studies (1959 participants) addressed subjective change in severity of rhinorrhoea. All studies were consistent in reporting statistically significant changes in favour of IB. Nasal congestion was reported in four studies and was found to have no significant change between the two groups. Two studies found a positive response in the IB group for the global assessment of overall improvement. Side effects were more frequent in the IB group, odds ratio (OR) 2.09 (95% confidence interval (CI) 1.40 to 3.11). Commonly encountered side effects included nasal dryness, blood tinged mucus and epistaxis. The overall risk of bias in the included studies was moderate. AUTHORS' CONCLUSIONS: For people with the common cold, the existing evidence, which has some limitations, suggests that IB is likely to be effective in ameliorating rhinorrhoea. IB had no effect on nasal congestion and its use was associated with more side effects compared to placebo or no treatment although these appeared to be well tolerated and self limiting. There is a need for larger, high-quality trials to determine the effectiveness of IB in relieving common cold symptoms. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/23784858/Intranasal_ipratropium_bromide_for_the_common_cold_ L2 - https://doi.org/10.1002/14651858.CD008231.pub3 DB - PRIME DP - Unbound Medicine ER -