One of the most vexed illnesses for which there continue to be no treatment guidelines is the common cold.
For years, people have turned to nonsteroidal anti-inflammatory drugs, or NSAIDs, to relieve pain, fever and other symptoms related to the miserable feelings brought on by the common cold. NSAIDs include ibuprofen, which is available in brands such as Motrin and Advil, and naproxen, which is marketed as Aleve.
A new Cochrane review of nine studies has found that NSAIDs are effective in reducing many cold symptoms. It is important to note, however, that NSAIDs can relieve symptoms of the common cold - not prevent or treat the illness.
"The review found that NSAIDs improved most analgesia-related symptoms such as headache, ear pain, and muscle and joint pain," said lead author Soo Young Kim, M.D., a professor at Hallym University Medical College in Seoul, South Korea. "We also found that NSAIDs significantly improved sneezing associated with the common cold."
Kim and his colleagues looked at whether NSAIDs were more effective than placebos for reducing common cold symptoms. The studies included 1,064 children and adults suffering from a cold. The participants did not have an acute illness or a chronic health condition. In six studies, 891 participants had acquired the cold before the study began, while 178 participants in three other studies were infected deliberately. Treatment duration ranged from a single dose to two doses a day for seven days.
The review appears in the latest issue of The Cochrane Library
, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions abut medical practice after considering both the content and quality of existing medical trials on a topic.
The investigators found that NSAIDs are beneficial in treating many cold symptoms, but not all cold symptoms. "That's due to the fact that many symptoms of the common cold are caused by inflammation due to viruses that do not appear in a single pathway," Kim said.
For example, reviewers found no clear evidence that NSAIDs are effective in improving respiratory symptoms such as cough and nasal discharge. "If a person has a cough caused by a cold, the American College of Chest Physicians has recommended the administration of naproxen," Kim said. "Further research is needed to evaluate the benefits of NSAIDs for relieving respiratory symptoms."
Norman Edelman M.D., chief medical officer of the American Lung Association, agrees with the review findings.
"Nonsteroidal anti-inflammatory drugs provide relief for many symptoms of the common cold," he said. "Even though they alleviate cold symptoms for many patients, it is unlikely that consumers expect NSAIDs to provide relief from all symptoms of the common cold. The review confirms the behavior of many consumers who are looking for a reduction of cold symptoms."
Edelman noted that while the review investigated common cold symptoms and not the flu, it did not distinguish the difference between cold and influenza symptoms.
"Even though fever is associated with the flu, not every person who is taking an NSAID recognizes that," he said. "If they are taking an NSAID to treat common cold symptoms, they may think their fever is due to a cold, but in realty, it may be influenza."
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.
Kim SY, et al. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database of Systematic Reviews Issue 3, 2009.