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Efficacy of Ambroxol lozenges for pharyngitis: a meta-analysis.

Chenot JF, Weber P, Friede T - BMC Fam Pract (2014)

Bottom Line: Main outcome was a ratio of pain reduction measured repeatedly over 3 h compared to baseline on 6-item verbal rating scale.However, the additional benefits of ambroxol beyond three hours, remain unclear given that more than 50% of patients using mint flavoured lozenges for pain relief reported good or very good efficacy after 1 day compared to 69% with ambroxol.Ambroxol is a safe option for individual patients with mainly local symptoms asking for treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Practice, University Medicine Greifswald, Ellernholzstr, 1-2, 17487 Greifswald, Germany. jchenot@uni-greifswald.de.

ABSTRACT

Background: Ambroxol has a local anaesthetic action and is marketed for pain relief for sore throat. The objective is to examine the efficacy and safety of ambroxol for the relief of pain associated with acute uncomplicated sore throat.

Methods: A systematic review of the literature and meta-analysis. Selection criteria consisted of randomized controlled trials which compared ambroxol to placebo or any other treatment for sore throat. Two reviewers independently assessed for relevance, inclusion, and risk of bias. Weighted mean differences (WMDs) were calculated and are reported with corresponding 95% confidence intervals (CIs).

Results and conclusion: From 14 potentially relevant citations, five trials reported in three publications met the inclusion criteria, three of them were published twice. Ambroxol lozenges were compared in different dosages (5-30 mg) with mint flavoured lozenges and once with benzocaine. Main outcome was a ratio of pain reduction measured repeatedly over 3 h compared to baseline on 6-item verbal rating scale. A total of 1.772 adult patients participated in the trials. Pain intensity decreased in both study arms. A meta-analysis of the 5 controlled trials resulted in a difference in pain reduction compared to placebo of -0.11 (95% CI [-0.15, -0.07]; p < 0.0001) favouring ambroxol 20 mg. Quality of reporting of the studies was low. Ambroxol is slightly more effective in relieving pain in acute sore throat than mint flavoured lozenges over a period of 3 h. However, the additional benefits of ambroxol beyond three hours, remain unclear given that more than 50% of patients using mint flavoured lozenges for pain relief reported good or very good efficacy after 1 day compared to 69% with ambroxol. Ambroxol is a safe option for individual patients with mainly local symptoms asking for treatment.

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Related in: MedlinePlus

Literature search results. * due to duplicate identification in different databases numbers do not add up to 48.
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Figure 1: Literature search results. * due to duplicate identification in different databases numbers do not add up to 48.

Mentions: Overall 14 potentially relevant publications were initially identified. We extracted five relevant RCTs reported in three publications [14-16]. Three RCTs were published twice [14,16]. One publication summarized all previously published trials providing additionally data from two so far unpublished trials in a so called EBM-based clinical documentation [15]. We identified additionally two unpublished registered and completed RCTs in the study registry ClinicalTrial.gov .These did not provide enough data to be included in the meta-analysis. All trials were financed by the manufacturer of ambroxol lozenges. The search process is described in FigureĀ 1.


Efficacy of Ambroxol lozenges for pharyngitis: a meta-analysis.

Chenot JF, Weber P, Friede T - BMC Fam Pract (2014)

Literature search results. * due to duplicate identification in different databases numbers do not add up to 48.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3975147&req=5

Figure 1: Literature search results. * due to duplicate identification in different databases numbers do not add up to 48.
Mentions: Overall 14 potentially relevant publications were initially identified. We extracted five relevant RCTs reported in three publications [14-16]. Three RCTs were published twice [14,16]. One publication summarized all previously published trials providing additionally data from two so far unpublished trials in a so called EBM-based clinical documentation [15]. We identified additionally two unpublished registered and completed RCTs in the study registry ClinicalTrial.gov .These did not provide enough data to be included in the meta-analysis. All trials were financed by the manufacturer of ambroxol lozenges. The search process is described in FigureĀ 1.

Bottom Line: Main outcome was a ratio of pain reduction measured repeatedly over 3 h compared to baseline on 6-item verbal rating scale.However, the additional benefits of ambroxol beyond three hours, remain unclear given that more than 50% of patients using mint flavoured lozenges for pain relief reported good or very good efficacy after 1 day compared to 69% with ambroxol.Ambroxol is a safe option for individual patients with mainly local symptoms asking for treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General Practice, University Medicine Greifswald, Ellernholzstr, 1-2, 17487 Greifswald, Germany. jchenot@uni-greifswald.de.

ABSTRACT

Background: Ambroxol has a local anaesthetic action and is marketed for pain relief for sore throat. The objective is to examine the efficacy and safety of ambroxol for the relief of pain associated with acute uncomplicated sore throat.

Methods: A systematic review of the literature and meta-analysis. Selection criteria consisted of randomized controlled trials which compared ambroxol to placebo or any other treatment for sore throat. Two reviewers independently assessed for relevance, inclusion, and risk of bias. Weighted mean differences (WMDs) were calculated and are reported with corresponding 95% confidence intervals (CIs).

Results and conclusion: From 14 potentially relevant citations, five trials reported in three publications met the inclusion criteria, three of them were published twice. Ambroxol lozenges were compared in different dosages (5-30 mg) with mint flavoured lozenges and once with benzocaine. Main outcome was a ratio of pain reduction measured repeatedly over 3 h compared to baseline on 6-item verbal rating scale. A total of 1.772 adult patients participated in the trials. Pain intensity decreased in both study arms. A meta-analysis of the 5 controlled trials resulted in a difference in pain reduction compared to placebo of -0.11 (95% CI [-0.15, -0.07]; p < 0.0001) favouring ambroxol 20 mg. Quality of reporting of the studies was low. Ambroxol is slightly more effective in relieving pain in acute sore throat than mint flavoured lozenges over a period of 3 h. However, the additional benefits of ambroxol beyond three hours, remain unclear given that more than 50% of patients using mint flavoured lozenges for pain relief reported good or very good efficacy after 1 day compared to 69% with ambroxol. Ambroxol is a safe option for individual patients with mainly local symptoms asking for treatment.

Show MeSH
Related in: MedlinePlus