Inhaled corticosteroids for subacute and chronic cough in adults: Cochrane Systematic Review

KJ Johnston, Anne Chang, Kwun M. Fong, RV Bowman, IA Yang

Research output: Contribution to journalMeeting Abstract


Background: Whilst current guidelines recommend inhaled corticosteroids (ICS) for persistent cough in adults, evidence is conflicting.

Methods: Cochrane methodology was used to systematically review all randomised trials of ICS versus placebo in adults with subacute or chronic cough.

Results: Eight studies of 570 participants were included. Heterogeneity in study design and reporting prevented meta-analysis for several outcomes. One parallel group trial of chronic cough which identified a significant treatment effect contributed the majority of statistical heterogeneity for the outcomes of proportion with clinical cure and/or improvement. While ICS treatment resulted in a mean decrease in cough score of 0.34 standard deviations (SMD −0.34; 95% CI −0.56 to −0.13; 346 participants), the quality of evidence was low. Heterogeneity also prevented meta-analysis for mean change in visual analogue scale score. Meta-analysis was not possible for pulmonary function, complications of cough or biomarkers of inflammation due to insufficient data. There was moderate quality evidence that treatment with ICS did not significantly increase the odds of experiencing an adverse event (OR 1.67; 95% CI 0.92 to 3.04).

Conclusion: The studies were highly heterogeneous and results were inconsistent. The factors that predict response to ICS could not be fully determined. Heterogeneity in study design needs to be addressed in future research.

Original languageEnglish
Pages (from-to)15-15
Number of pages1
Issue numberS2
Publication statusPublished - 2013
EventThoracic Society of Australia & New Zealand and the Australian & New Zealand Society Annual Scientific Meeting - Darwin Convention Centre, Darwin, Australia
Duration: 22 Mar 201327 Mar 2013


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