Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis

Harri Hemilä, James T. Fitzgerald, Edward J. Petrus, Ananda Prasad

Research output: Contribution to journalArticleScientificpeer-review

Abstract

BACKGROUND:
A previous meta-analysis of 3 zinc acetate lozenge trials estimated that colds were on average 40% shorter for the zinc groups. However, the duration of colds is a time outcome, and survival analysis may be a more informative approach. The objective of this individual patient data (IPD) meta-analysis was to estimate the effect of zinc acetate lozenges on the rate of recovery from colds.
METHODS:
We analyzed IPD for 3 randomized placebo-controlled trials in which 80-92 mg/day of elemental zinc were administered as zinc acetate lozenges to 199 common cold patients. We used mixed-effects Cox regression to estimate the effect of zinc.
RESULTS:
Patients administered zinc lozenges recovered faster by rate ratio 3.1 (95% confidence interval, 2.1-4.7). The effect was not modified by age, sex, race, allergy, smoking, or baseline common cold severity. On the 5th day, 70% of the zinc patients had recovered compared with 27% of the placebo patients. Accordingly, 2.6 times more patients were cured in the zinc group. The difference also corresponds to the number needed to treat of 2.3 on the 5th day. None of the studies observed serious adverse effects of zinc.
CONCLUSIONS:
The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.
Original languageEnglish
Article numberofx059
JournalOpen Forum Infectious Diseases
Volume4
Issue number2
Number of pages6
ISSN2328-8957
DOIs
Publication statusPublished - 3 Apr 2017
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3142 Public health care science, environmental and occupational health
  • 317 Pharmacy
  • 3125 Otorhinolaryngology, ophthalmology
  • common cold
  • meta-analysis
  • randomized controlled trials
  • respiratory tract infections
  • zinc acetate

Cite this

@article{5b5a3cc8dd4f4da5aaab88ce31d3338b,
title = "Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis",
abstract = "BACKGROUND:A previous meta-analysis of 3 zinc acetate lozenge trials estimated that colds were on average 40{\%} shorter for the zinc groups. However, the duration of colds is a time outcome, and survival analysis may be a more informative approach. The objective of this individual patient data (IPD) meta-analysis was to estimate the effect of zinc acetate lozenges on the rate of recovery from colds.METHODS:We analyzed IPD for 3 randomized placebo-controlled trials in which 80-92 mg/day of elemental zinc were administered as zinc acetate lozenges to 199 common cold patients. We used mixed-effects Cox regression to estimate the effect of zinc.RESULTS:Patients administered zinc lozenges recovered faster by rate ratio 3.1 (95{\%} confidence interval, 2.1-4.7). The effect was not modified by age, sex, race, allergy, smoking, or baseline common cold severity. On the 5th day, 70{\%} of the zinc patients had recovered compared with 27{\%} of the placebo patients. Accordingly, 2.6 times more patients were cured in the zinc group. The difference also corresponds to the number needed to treat of 2.3 on the 5th day. None of the studies observed serious adverse effects of zinc.CONCLUSIONS:The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.",
keywords = "3142 Public health care science, environmental and occupational health, 317 Pharmacy, 3125 Otorhinolaryngology, ophthalmology, common cold, meta-analysis, randomized controlled trials, respiratory tract infections, zinc acetate",
author = "Harri Hemil{\"a} and Fitzgerald, {James T.} and Petrus, {Edward J.} and Ananda Prasad",
year = "2017",
month = "4",
day = "3",
doi = "10.1093/ofid/ofx059",
language = "English",
volume = "4",
journal = "Open Forum Infectious Diseases",
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Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients : An Individual Patient Data Meta-Analysis. / Hemilä, Harri; Fitzgerald, James T.; Petrus, Edward J.; Prasad, Ananda.

In: Open Forum Infectious Diseases, Vol. 4, No. 2, ofx059, 03.04.2017.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients

T2 - An Individual Patient Data Meta-Analysis

AU - Hemilä, Harri

AU - Fitzgerald, James T.

AU - Petrus, Edward J.

AU - Prasad, Ananda

PY - 2017/4/3

Y1 - 2017/4/3

N2 - BACKGROUND:A previous meta-analysis of 3 zinc acetate lozenge trials estimated that colds were on average 40% shorter for the zinc groups. However, the duration of colds is a time outcome, and survival analysis may be a more informative approach. The objective of this individual patient data (IPD) meta-analysis was to estimate the effect of zinc acetate lozenges on the rate of recovery from colds.METHODS:We analyzed IPD for 3 randomized placebo-controlled trials in which 80-92 mg/day of elemental zinc were administered as zinc acetate lozenges to 199 common cold patients. We used mixed-effects Cox regression to estimate the effect of zinc.RESULTS:Patients administered zinc lozenges recovered faster by rate ratio 3.1 (95% confidence interval, 2.1-4.7). The effect was not modified by age, sex, race, allergy, smoking, or baseline common cold severity. On the 5th day, 70% of the zinc patients had recovered compared with 27% of the placebo patients. Accordingly, 2.6 times more patients were cured in the zinc group. The difference also corresponds to the number needed to treat of 2.3 on the 5th day. None of the studies observed serious adverse effects of zinc.CONCLUSIONS:The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.

AB - BACKGROUND:A previous meta-analysis of 3 zinc acetate lozenge trials estimated that colds were on average 40% shorter for the zinc groups. However, the duration of colds is a time outcome, and survival analysis may be a more informative approach. The objective of this individual patient data (IPD) meta-analysis was to estimate the effect of zinc acetate lozenges on the rate of recovery from colds.METHODS:We analyzed IPD for 3 randomized placebo-controlled trials in which 80-92 mg/day of elemental zinc were administered as zinc acetate lozenges to 199 common cold patients. We used mixed-effects Cox regression to estimate the effect of zinc.RESULTS:Patients administered zinc lozenges recovered faster by rate ratio 3.1 (95% confidence interval, 2.1-4.7). The effect was not modified by age, sex, race, allergy, smoking, or baseline common cold severity. On the 5th day, 70% of the zinc patients had recovered compared with 27% of the placebo patients. Accordingly, 2.6 times more patients were cured in the zinc group. The difference also corresponds to the number needed to treat of 2.3 on the 5th day. None of the studies observed serious adverse effects of zinc.CONCLUSIONS:The 3-fold increase in the rate of recovery from the common cold is a clinically important effect. The optimal formulation of zinc lozenges and an ideal frequency of their administration should be examined. Given the evidence of efficacy, common cold patients may be instructed to try zinc acetate lozenges within 24 hours of onset of symptoms.

KW - 3142 Public health care science, environmental and occupational health

KW - 317 Pharmacy

KW - 3125 Otorhinolaryngology, ophthalmology

KW - common cold

KW - meta-analysis

KW - randomized controlled trials

KW - respiratory tract infections

KW - zinc acetate

U2 - 10.1093/ofid/ofx059

DO - 10.1093/ofid/ofx059

M3 - Article

VL - 4

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

SN - 2328-8957

IS - 2

M1 - ofx059

ER -