A cold cough is rarely caused by bacteria; in the vast majority of cases, it is a symptom of a viral infection. Symptom-relieving preparations can alleviate the symptoms and shorten the duration of the illness. The results of a meta-analysis by Kardos et al. show that a standardized Pelargonium sidoides special extract alleviates cough symptoms, improves quality of life and reduces productivity losses.
In acute respiratory infections such as colds and bronchitis, cough is a leading symptom and a frequent reason for consultation in primary care [1]. The pathogen is often an influenza A or B virus with simultaneous or previous upper respiratory tract infection (rhinitis, sinusitis, pharyngitis, laryngitis). The spontaneous course of uncomplicated acute bronchitis lasts on average around 2-3 weeks. Although viral cough symptoms are often self-limiting in otherwise healthy people, symptomatic treatment can be useful to reduce the level of suffering.
Database with a total of over 2000 participants
The herbal medicine Kaloba®, which is based on the active ingredient EPs® 7630, is approved for the treatment of acute bronchitis in Switzerland and other countries [2]. The standardized Pelargonium sidoides extract EPs® 7630 is obtained from the roots of Cape geranium. In numerous studies, EPs® 7630 showed a combination of antiviral, antibacterial and mucolytic effects. Kardos et al. conducted a meta-analysis to find out more about the extent to which treatment with EPs® 7630 can reduce cough and improve disease-related quality of life [3]. They included 11 randomized, placebo-controlled trials investigating the efficacy of EPs® 7630 in acute bronchitis and the common cold. In total, data from 2195 participants were included in the meta-analysis. In three of the studies, the effects of the Pelargonium special extract were investigated in children/adolescents and in adults with acute bronchitis respectively, and in five studies the focus was on the effects on the common cold. Explanations of the methodology used in the study are summarized in thebox. It is important to note that in this context a ” risk ratio ” (R R) >1.0 means that the probability of remission is higher with EPs® 7630 than with placebo.
| Methodology of the study: two-stage procedure |
| Kardos et al.
used a method in which the parameters of interest were first analyzed individually within each study and then combined in the sense of a classic meta-analysis.
In the first step, the cough scores were determined by calculating the intraindividual difference between the baseline value and day 5 or day 7.
These mean values and their estimated standard deviations were used as input for the meta-analyses performed in the second step. Response was defined as at least a 50% reduction in symptom severity or loss of quality of life compared to baseline. Consequently, higher rates indicate a more favorable outcome (e.g. a higher proportion of patients without any cough symptoms). The resulting risk ratios >1.0 mean that the probability of remission is higher with EPs® 7630 than with placebo, i.e. the use of the phytotherapeutic agent has proven to be effective (RR=Risk Ratio). |
| to [3,4] |
Acute bronchitis: In children/adolescents with acute bronchitis, 79.6% of participants treated with EPs® 7630 and 41% of the placebo group showed a reduction in cough intensity of at least 50% of baseline values on day 7 [3]. The risk ratio (RR) of EPs® 7630 to placebo was 1.86 (95% CI: 1.34-2.95). Complete cough remission occurred in 18.0% and 5.5% of study participants on EPs® 7630 and placebo respectively (RR: 2.91; 95% CI: 1.26-6.72).
In adults with acute bronchitis, 88.7% of participants in the EPs® 7630 group and 47.6% in the placebo group showed a ≥50% response in terms of cough intensity (RR: 2.13; 95% CI: 1.37-3.31), while 26.0% and 6.3% no longer coughed on day 7 (RR: 5.00; 95% CI; 3.10-8.07).
In addition, EPs® 7630 proved to be superior to placebo in terms of improvements in the performance of daily activities and in other quality of life measures.
Common cold: With a normal cold, 56.8% of participants treated with EPs® 7630 and 38.8% of the placebo group showed a reduction in cough intensity of ≥50% on the fifth day (RR: 1.40; 95% CI: 1.19-1.65), while complete cough remission was seen in 26.1% and 18.4% with EPs® 7630 and placebo respectively (RR: 1.40; 95% CI: 1.06- 1.84) [3]. In addition, 48.8% and 41.5% of participants in the pelargonium arm were free of impairment in daily activities and pain/discomfort, respectively, while the corresponding values for placebo were 38.2% and 38.6%.
Conclusion
In summary, these results indicate that EPs® 7630 reduces the stress associated with acute bronchitis and colds and leads to an earlier remission of cough symptoms compared to the placebo [3]. The Pelargonium special extract also proved to be beneficial in terms of self-assessed quality of life. The study authors emphasize that patients treated with the phytopharmacological preparation felt able to resume their usual daily activities earlier and thus had less loss of productivity [3].
Literature:
- Kardos P: Akuter und chronischer Husten – gibt es etwas Neues? [Acute and chronic cough-What is new?]. Pneumologe (Berl) 2020;17(6): 433–442.
- Swissmedic: Medicinal product information, www.swissmedicinfo.ch,(last accessed 24.07.2024)
- Kardos P, et al.: Effects of Pelargonium sidoides extract EPs 7630 on acute cough and quality of life – a meta-analysis of randomized, placebo-controlled trials. Multidiscip Respir Med 2022 Aug 3; 17: 868.
- Burke DL, Ensor J, Riley RD: Meta-analysis using individual participant data: one-stage and two-stage approaches, and why they may differ. Stat Med 2017; 36: 855–875.
HAUSARZT PRAXIS 2024: 19(8): 26
PHYTOTHERAPIE PRAXIS 2024; 1(1): 15
