Efficacy of oral corticosteroid versus placebo in symptomatic treatment of cough : a systematic review and meta-analysis of randomized clinical trials.
Creators: name: Fanély, CHARRA
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences

description: Cough is an important reason for consultation in France. This can be explained by the high prevalence of this symptom and its impact on the quality of life. Oral corticosteroids widely used as etiological treatment in various respiratory diseases, including asthma and COPD, especially for exacerbations. They also used for bronchitis. But there are few data on its effectiveness as a symptomatic treatment of cough. This study aims to report current knowledge. Team members and their organisational affiliations: First Author : Irène SUPPER, CUMG, UCBL Lyon 1, France Last Authors : Rémy BOUSSAGEON, MD, PhD, Collège Universitaire de Médecine Générale ; UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Claude-Bernard Lyon 1 University, CNRS, Lyon, France. Pr Nematollah JAAFARI : CNRS 3557, CIC-P 1402 and clinical research unit, Henri Laborit Hospital, 370 av. Jacques cœur, CS 10587, 86021 Poitiers Dr Hélène VAILLANT-ROUSSEL : Department of General Medicine and UPU ACCePPT, University of Auvergne Clermont-Ferrand Cedex 1, France28 place Henri Dunant, BP 38, 63001 CLERMONT-FERRAND Cedex 1. ORCID: 0000-0002-3384-0335 Dr Denis POUCHAIN : Department of General Medicine, University of of Tours, 10 boulevard Tonnelé, BP 3223, 37032 Tours Cedex 1. ORCID: 0000-0001-6882-3474 Fanely CHARRA, interne de médecine générale à la faculté de médecine de Lyon Est Camille PELTIER, interne de médecine générale à la faculté de médecine de Lyon Est We will use the search free-access databases of Cochrane library and Pubmed and EMBASE using the key word : glucorticoids, betamethasone, dexamethasone, methylprednisolone, prednisolone, prednisone AND cough AND randomized controlled trials. Electronic databases were searched for studies published until October 2020. All studies in english and in french will be used. Domain being studied: cough no matter the etiology Population: both age and genders Intervention: Administrations of oral corticosteroids for cough no matter the etiology. Search about betamethasone, dexamethasone, methylprednisolone, prednisolone, prednisone. Comparator: administration of placebo Types of study: Randomized controlled versus placebo trials available in French or English Primary outcome: Cough relief with a binary response pattern: yes or no. Secondary outcomes: - Cough relief with a continuous outcome: standard mean difference ? - duration of cough - quality of life - Adverse event Data extraction: Titles and/or abstracts of studies retrieved using the search strategy will be screened independently by two review authors to identify studies that potentially meet the inclusion criteria outlined above. The full text of these potentially eligible studies will be retrieved and independently assessed for eligibility by two review team members (FC and CP). Any disagreement between them over the eligibility of particular studies will be resolved through discussion with a third reviewer. Extracted information will include: study setting; study population and participant demographics and baseline characteristics; details of the intervention and control conditions; study methodology; recruitment and study completion rates; outcomes and times of measurement; indicators of acceptability to users; suggested mechanisms of intervention action; information for assessment of the risk of bias. Two review authors will extract data independently, discrepancies will be identified and resolved through discussion (with a third author where necessary). Missing data will be requested from study authors. Risk of bias (quality) assessment: Two review authors will independently assess the risk of bias (COCHRANE’s TOOL) in included studies by considering the following characteristics: - Selection biais: sequence generation and allocation concealment - Performance biais: blinding of participants and personnel. - Detection/observer biais: blinding of outcome assessment - Attrition biais: incomplete outcome data. - Reporting biais: selective reporting - Other potential biaises (stop early, sponsor). = Sensitivity analysis : (high risk vs low risk) Strategy for data synthesis: As we suspect the studies included will be heterogeneous, a narrative/descriptive synthesis is planned. We will provide summaries of intervention effects for each study by calculating risk ratios (response, or no response). Analysis of subgroups or subsets: - according to etiology - according chronic cough/ acute and sub-acute cough - according children/adult - according duration of treatment