Meta AnalysisID 1942

可待因镇咳药对比安慰剂对咳嗽症状性治疗的疗效：随机对照试验的系统评价与Meta分析

CRD42023373868

What is the clinical efficacy of codeine antitussive agents in coughs?

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Meta Analysis Id: 1942
Evidence Id: 10500
Core Evidence Id: 10500
Source Meta Analysis Id: 1885
Herb2 Meta Analysis Id: HBMA001885
Crd Id: CRD42023373868
Title: The efficacy of codeine antitussive agents versus placebo in symptomatic treatment of cough: a systematic review and meta-analysis of randomized controlled trials
Review Question: What is the clinical efficacy of codeine antitussive agents in coughs?
Study Type Included: We will include randomised controlled trials published in peer-reviewed journals and clinical trial registries. Cough assessment should be assessed as outcomes (primary or secondary outcomes). If the trial has not been published, but identified in a clinical trial registry, we will attempt to contact the authors for additional data. There will be restrictions on the language (French or English langage only).
Condition Being Studied: Adults subjects and Children (>1 year old) with Coughs, regardless of etiology. Coughs should not be caused by inhalation of citric acid or capsaicin.
Participant: People of both genders, aged 2 years, with a cough regardless of etiology.
Animal
Human Disease Modelled
Intervention: Eligible randomized controlled trials ( RCTs ) investigated the effectiveness of oral codeine cough suppressant treatment compared to placebo. Trials will still be eligible for inclusion if they investigated codeine cough suppressants as an add-on to treatment such as paracetamol, but we will not include comparisons with active treatments. The dose and frequency of intake will not be limited.
Comparator Control: The control will be placebo only. Studies concerning multi-component drugs are excluded because we are interested in the effect of pure molecules.
Main Outcome: Cough relief, as assessed based on a binary response pattern (yes or no) OR continu (echelle). Cough assessment is measured by two methods: - a subjective questionnaire of cough severity or frequency. - an objective measurement of the coughing efforts of the patients by a microphone recording. Measures of effect For all outcomes, the number of events in each group will be extracted. As much as possible, we will pool the risk ratios reported in the studies as these are often hazard ratios or adjusted risk ratios. For dichotomous (binary or qualitative) outcomes, we will calculate Risk Ratios (RR) with 95% CIs from the number of events and participants in each treatment group. For continuous (echelle, quantitative) outcomes, we will calculate the mean difference (or SMD standardised mean differences if necessary because of the diversity of assessment scales) with 95% CIs. If events are very rare (0 or 1 in each group of the RCT), we will pool data using Peto’s methods (because corrections for zero cell counts are not necessary) with reported pooled Peto odds ratios and associated 95% CIs.
Outcome Measure
Additional Outcome: Other pain outcomes (e.g, cough intensity, quality of life; Effects on sleep, adverse events (i.e., dizziness, drowsiness, vomiting, transit disorder, allergic reaction, hallucinations, dependence) and any serious adverse event (i.e., life-threatening or resulting in hospital admission, or reported as a serious adverse event by the study authors), the number and nature of those adverse/serious adverse events, and the number of withdrawals due to adverse events. Measures of effect For all outcomes, the number of events in each group will be extracted. As much as possible, we will pool the risk ratios reported in the studies as these are often hazard ratios or adjusted risk ratios. For dichotomous (binary or qualitative) outcomes, we will calculate Risk Ratios (RR) with 95% CIs from the number of events and participants in each treatment group. For continuous (echelle, quantitative) outcomes, we will calculate the mean difference (or SMD standardised mean differences if necessary because of the diversity of assessment scales) with 95% CIs. If events are very rare (0 or 1 in each group of the RCT), we will pool data using Peto’s methods (because corrections for zero cell counts are not necessary) with reported pooled Peto odds ratios and associated 95% CIs.
Study Method: Intervention, Meta-analysis, Narrative synthesis, Synthesis of qualitative studies, Systematic review
Keyword: Antitussive Agents; Codeine; Cough; Humans; Randomized Controlled Trials as Topic; Treatment Outcome
Contact: Margaux FERRIER [email protected]
Organisational Affiliation: Collège Universitaire de Médecine Générale, Université Lyon 1, France https://lyon-est.univ-lyon1.fr/formation/des-medecine-generale/college-universitaire-de-medecine-generale-cumg
Funding Source: No sponsor.
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language: English, French
Country: France
Review Stage: Review Ongoing
First Submission Date: 2023-01-12
Registration Date: 2023-01-23
Anticipated Start Date: 2022-12-10
Anticipated Completion Date: 2023-02-10
Title Cn: 可待因镇咳药对比安慰剂对咳嗽症状性治疗的疗效：随机对照试验的系统评价与Meta分析
Title En: The efficacy of codeine antitussive agents versus placebo in symptomatic treatment of cough: a systematic review and meta-analysis of randomized controlled trials
Bilingual Status: complete