sábado, 1 de agosto de 2009

NSAIDs Recommended for Relieving Discomfort, Pain Caused by the Common Cold

July 20, 2009 — Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for relieving discomfort or pain caused by the common cold, according to the results of a review reported online in the July 8 issue of the Cochrane Database of Systematic Reviews.
"Although...NSAIDs have been widely used for the treatment of pain and fever associated with the common cold, there is no systematic review to assess the effects of NSAIDs in patients with the common cold," write Soo Young Kim, from Kangdong Sacred Heart Hospital in Seoul, South Korea, and colleagues. "There is some evidence that cold symptoms might be the result of inflammatory mediators such as kinins and prostaglandins, which can be blocked by NSAIDs, rather than the result of the direct cytopathic effects of viruses."
The goals of this systematic review were to evaluate the effects of NSAIDs vs placebo and other treatments on the signs and symptoms of the common cold and to identify any adverse effects of NSAIDs in patients receiving them for relief of common cold symptoms.
The reviewers searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, issue 1), which includes the Acute Respiratory Infections Group's Specialized Register, MEDLINE from January 1966 to March 2009, EMBASE from January 1980 to March 2009, CINAHL from January 1982 to March 2009, ProQuest Digital Dissertations from January 1938 to March 2009, KoreaMed from January 1958 to March 2009, and KMbase from January 1949 to March 2009.
NSAID treatment was associated with significant benefits for outcomes related to analgesic effects on headache, ear pain, and muscle and joint pain. Although throat irritation was not relieved, there was a borderline benefit for malaise and mixed results for chills.
With respiratory tract symptoms, the sneezing score significantly improved, but there was no improvement in scores for cough and nasal discharge. The NSAID treatment groups had no apparent evidence of increased frequency of adverse effects.
"The authors recommend NSAIDs for relieving discomfort or pain caused by the common cold," the review authors write. "Further research is needed to investigate the effect of NSAIDs in relieving respiratory symptoms such as cough and nasal discharge."
Limitations of this review include mixed methodologic quality of the included studies, largely because of missing information regarding randomization procedures. In addition, the review did not address the comparison of acetaminophen vs NSAIDs.
"We were unable to exclude the theory that NSAIDs are effective in reducing cough based upon the data included in this review," the authors conclude. “A large trial to study NSAIDs in colds may make this relationship clearer."
Clinical Implications
Use of NSAIDs for the common cold is associated with a reduction in pain and earache symptoms.
Use of NSAIDs for the common cold is not associated with the relief of nonanalgesic cold symptoms, and only ibuprofen is associated with more adverse effects vs placebo.

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