Intervention Review

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Intranasal ipratropium bromide for the common cold

  1. Zaina H AlBalawi1,*,
  2. Sahar S Othman2,
  3. Khalid AlFaleh3

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 19 JUN 2013

Assessed as up-to-date: 9 APR 2013

DOI: 10.1002/14651858.CD008231.pub3

How to Cite

AlBalawi ZH, Othman SS, AlFaleh K. Intranasal ipratropium bromide for the common cold. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD008231. DOI: 10.1002/14651858.CD008231.pub3.

Author Information

  1. 1

    University of Alberta, Department of Medicine, Edmonton, Alberta, Canada

  2. 2

    College of Medicine, King Abdulaziz University Hospital, Department of Family and Community Medicine, Jeddah, western, Saudi Arabia

  3. 3

    King Saud University, Department of Pediatrics (Division of Neonatology), Riyadh, Saudi Arabia

*Zaina H AlBalawi, Department of Medicine, University of Alberta, 11106 83 ave, Edmonton, Alberta, T6G0V1, Canada. Zaina.albalawi@ualberta.ca. Zaina7rb@yahoo.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 19 JUN 2013

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Characteristics of included studies [ordered by study ID]
Borum 1981

MethodsRandomised controlled trial


ParticipantsNumber randomised: 41 (1 was excluded because he lost his completed symptom card), 21 in treatment group and 19 in placebo

Setting: out-patient, Denmark

Study period: October to November 1979

Age: treatment group mean age 23.5 (21 to 38), placebo group mean age 24.6 (21 to 28)

Sex: 12 men and 9 women in the treatment group,10 men and 9 women in the placebo group

Diagnostic criteria: participants felt confident that they had caught a cold and had sudden onset of rhinorrhoea and attacks of sneezing and/or nasal blockage < 24 hours

Inclusion criteria: medical students who feel confident that they had caught a cold and have sudden onset of rising rhinorrhoea and attacks of sneezing and/or nasal blockage for less than 24 hours, had no history of allergic, chronic or recurrent airway disease or frequent complications to common colds (sinuitis or bronchitis), were able to produce enough macroscopic non-purulent secretion for microscopic examination (at least 1.0 ml), had no eosinophilia in the secretion (more than 10% of all leukocytes) and gave informed consent to participate

Exclusion criteria: any participant who did not fulfil the inclusion criteria

Aetiology: natural


InterventionsIntervention: ipratropium was given from a Freon-propelled pressurised canister used for inhalation therapy, it was equipped with a nasal adapter. The dose was 1 puff of 20 micrograms in the upper and 1 puff of 20 micrograms in the lower part of each nostril 4/day for 7 days

Control: the placebo aerosol contained Freon alone. The dose was 1 puff of 20 micrograms in the upper and 1 puff of 20 micrograms in the lower part of each nostril 4/day for 7 days

Note: a vasoconstrictor spray (xylometazoline) was taken 5 min before each medication of both groups of subjects in order to ensure adequate mucosal distribution


OutcomesPrimary: number of paper handkerchiefs used per day

Other outcomes reported: number of sneezes per day, type of nasal secretion and side effects


NotesFunding source: unclear, Boehringer Ingelheim supplied the Atrovent and placebo aerosols

Conflict of interest: not stated

Calculated sample size: not stated


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "Subjects were allocated at random to the ipratropium group or to the placebo group"

Comment: insufficient information to judge

Allocation concealment (selection bias)Unclear riskInsufficient data

Blinding (performance bias and detection bias)
All outcomes
Unclear riskNot addressed

Incomplete outcome data (attrition bias)
All outcomes
Low riskQuote: "one was rejected later because he lost his completed symptom card"

Comment: no further missing data

Selective reporting (reporting bias)Low riskAll outcomes mentioned in the methods appear clearly in the results section

Other biasUnclear riskAtrovent and placebo aerosols were provided by Boehringer Ingelheim; no further details provided in regards to their involvement in the study or not

Diamond 1995

MethodsRandomised controlled trial (5-arm study, 3 groups received IB treatment with different concentrations and the other 2 were control groups who received placebo or no treatment)


ParticipantsNumber randomised: 955 (only 943 completed the study), 568 in treatment groups (188, 189 and 191 in groups receiving IB 0.12%, 0.06% and 0.03%), 375 in control group (188 vehicle and 187 no treatment)

Setting: out-patient. The study was conducted at 6 geographically diverse sites in the United States

Study period: 30 October 1990 to 29 March 1991

Age: range 12 to 70 years, mean age is 27.5 for all groups

Sex: 492 male and 463 female

Diagnostic criteria: subjective reporting of a moderate or greater degree of rhinorrhoea present for no more than 36 hours

Inclusion criteria: (1) swollen, erythematous nasal mucosal membranes on visual examination; (2) subjective reporting of a moderate or greater degree of rhinorrhoea present for no more than 36 hours; and (3) production of 1.5 g or more of nasal discharge during a 1-hour baseline measurement period

Exclusion criteria: participants were excluded from the study if they had significant cardiovascular, renal, hepatic, endocrine, metabolic, neurologic, pulmonary or other systemic disease or if they had a history of asthma or other chronic respiratory disease, perennial rhinitis, nasal polyps, glaucoma or unresolved prostatic hypertrophy. Participants with allergic rhinitis were excluded if their allergen was in season or ubiquitous in their environment (for example, animal dander). A positive Streptococcus culture, the presence of rales or rhonchi indicative of a lower respiratory tract infection, an oral temperature of higher than 102°F, or a history of frequent complications such as sinusitis or bronchitis arising from an upper respiratory tract infection. Also excluded were lactating women, with positive results of a pregnancy test, of childbearing potential who were not using a medically approved method of contraception, persons judged incapable of accurately maintaining a symptom record form and individuals who could not tolerate anticholinergic drugs or who were sensitive to the preservative present in the IB nasal spray vehicle; benzalkonium chloride

Aetiology: natural


InterventionsTreatment: each participant got a nasal spray which delivered 0.07 ml per actuation. Three concentrations of IB nasal spray were used: 0.03%, 0.06% and 0.12%. The dose of each concentration was 2 sprays (yielding 42, 84 or 168 micrograms) in each nostril 3 times daily for 4 days

Control: 2 groups; 1 received a vehicle (a buffered saline solution) nasal spray that delivered 0.07 ml/actuation, dose was 2 sprays 3/day for 4 days. The other group received no treatment


Outcomes2 primary efficacy endpoints were selected to detect changes in rhinorrhoea: nasal discharge weights and in-clinic VAS scores

Secondary efficacy endpoints were the daily at-home VAS scores for rhinorrhoea, sneezing and nasal congestion

Other outcomes reported: adverse events


NotesFunding source: not stated

Conflict of interest: not stated

Calculated sample size: not stated


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "Patients were randomly assigned to receive either no treatment, vehicle treatment, or treatment with IB nasal spray."

Comment: insufficient information to judge

Allocation concealment (selection bias)Unclear riskInsufficient data

Blinding (performance bias and detection bias)
All outcomes
Unclear riskQuote: "The study was double-blind with respect to IB and vehicle"

Comment: insufficient information to judge

Incomplete outcome data (attrition bias)
All outcomes
High risk12 patients were not included in data analysis and no further information provided

Selective reporting (reporting bias)Low riskAll outcomes stated in the methods were mentioned in the results section

Other biasLow risk

Dockhorn 1992

MethodsRandomised controlled trial


ParticipantsNumber randomised: 321 participants, 159 in the treatment group and 162 in the placebo group (317 were included in ITT analysis and 301 in full efficacy analysis)

Setting: out-patient, multicentre, USA

Study period: not stated

Age: mean age 29

Sex: 144 male and 177 female

Diagnostic criteria: moderate rhinorrhoea for less than 36 hours

Inclusion criteria: moderate rhinorrhoea for less than 36 hours and swollen, erythematous nasal mucosa on examination

Exclusion criteria: significant cardiovascular, renal, hepatic, endocrine, metabolic, neurologic, pulmonary or other systemic disease. History of asthma or other chronic respiratory disease, perennial rhinitis, nasal polyps, glaucoma, or unresolved prostatic hypertrophy. Participants with allergic rhinitis were excluded if their allergen was in season or ubiquitous in their environment (for example, animal dander). A positive Streptococcus culture, the presence of rales or rhonchi indicative of a lower respiratory tract infection, an oral temperature of higher than 102°F, or a history of frequent complications such as sinusitis or bronchitis arising from an upper respiratory tract infection. Lactating women, women with positive results of a pregnancy test, of childbearing potential who were not using a medically approved method of contraception. Persons judged incapable of accurately maintaining a symptom record form, and individuals who could not tolerate anticholinergic drugs or who were sensitive to the preservative present in the IB nasal spray vehicle, benzalkonium chloride

Aetiology: natural


InterventionsTreatment: nasal spray, each delivered 42 micrograms of IB; at each dose 2 sprays were delivered to each nostril for a total of 84 micrograms per nostril per dose, taken 4/day for 4 days

Control: placebo nasal spray 4/day for 4 days


OutcomesPrimary endpoints to evaluate change in rhinorrhoea: average weight of nasal discharge over 3 hours on days 1 and 2 of drug administration, change from baseline in patients' evaluation of rhinorrhoea symptoms using VAS over 3 hours on days 1 and 2 and for both days' average versus baseline and change from baseline in rhinorrhoea symptoms as evaluated by participants using VAS, averaged during days 1 and 2 and separately averaged during days 3 and 4

Secondary: VAS for sneezing and nasal congestion, averaged separately for days 1 and 2, then days 3 and 4

Other outcomes reported: adverse events and nasal examination changes


NotesFunding source: not stated

Conflict of interest: not state

Calculated sample size: not stated


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "before randomizations to either drug or placebo..."

Comment: insufficient information to judge

Allocation concealment (selection bias)Unclear riskInsufficient data

Blinding (performance bias and detection bias)
All outcomes
Unclear riskQuote: "The study was a double-blind..."

Comment: insufficient information to judge

Incomplete outcome data (attrition bias)
All outcomes
High riskQuote: "321 participants were enrolled (159 received IB and 162 received placebo). Of these, 317 were included in the intent-to-treat analysis, and 301 were included in the full efficacy analysis."

Comment: no explanation for missing data and dropouts

Selective reporting (reporting bias)Low riskAll outcomes sated in the methods appear clearly in the results section

Other biasLow risk

Eccles 2007

MethodsRandomised controlled trial (5-arm study, 2 groups received combination of IB and xylometazoline with different concentrations; the other 3 groups received: IB alone, xylometazoline alone or no treatment)


ParticipantsNumber randomised 786 (number completed the study 703)
Intervention group receiving IB: 154, control group receiving no treatment: 157

Setting: out-patient, multicentre based in the United Kingdom, Denmark, Finland, Norway and Sweden

Study period: not stated

Age: 18 or older, mean age of intervention group 28.9 (18 to 59) and mean age of control group 30 (18 to 70)

Sex: 85 female and 69 male in the intervention group, 73 female and 84 male in the control group

Diagnostic criteria: history of common cold symptoms of 36 hours

Inclusion criteria: age 18 years or older, history of common cold symptoms of 36 hours, a rhinorrhoea score of at least 2 (moderate) and a nasal congestion score of at least 2 (moderate)

Exclusion criteria: evidence or history of hypersensitivity to study medications, significant cardiovascular or endocrine disorders, perennial allergic rhinitis, nasal polyps or significant nasal abnormalities. Narrow-angle glaucoma, prostatic hypertrophy, sinusitis, bronchitis, pregnancy or lactation, inadequate contraception over trial period in fertile females. Rhinitis medicamentosa, use of nasal decongestants or antisecretory medicines within the last week, use of monoamine oxidase inhibitors within the previous month, use of tricyclic antidepressants. Rhinitis that required medical attention, and/or extensive physical activity during treatment

Aetiology: natural


InterventionsIntervention group: ipratropium, 0.6 mg/ml

Control group: placebo solution

For all groups, the test treatments were formulated as preservative-free aqueous solutions in nasal multiple-dose spray devices consisting of a glass bottle (Fiolax brown type I), a non-vented pump and an actuator. The nasal spray had a declared volume of 10 ml and delivered a dose of 140 microlitre. Participants took 1 spray in each nostril 3/day


OutcomesThe primary efficacy variables were subjective ratings of severity of rhinorrhoea and nasal congestion after the first 24-hour period

Secondary efficacy variables for rhinorrhoea: tissue use over the first 24 hours

Other outcomes: general impression score of test treatment after the first 24-hour period and at the end of the study and adverse events


NotesFunding source: not stated

Conflict of interest: not stated

Calculated sample size: yes. The sample size was based on the 2 independent primary end points, rhinorrhoea and nasal congestion, during the first 24 hours. Participants per group: 150


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskQuote: "patients were allocated to treatment according to a randomised sequence prepared by the Nycomed Company"

Comment: probably done

Allocation concealment (selection bias)Low riskQuote: "Patients were allocated to treatment according to a randomisation sequence prepared by the Nycomed Co. The randomisation key was kept in sealed envelopes, only to be opened in case of emergency."

Comment: probably done

Blinding (performance bias and detection bias)
All outcomes
Unclear riskQuote: "The test formulations were in identical spray bottles to blind the study."

Comment: insufficient information regarding blinding the investigators and analysts

Incomplete outcome data (attrition bias)
All outcomes
Low riskQuote: "Eighty-three patients did not complete the study; 55 patients withdrew due to adverse events as listed previously, 8 patients withdrew because of lack of effect of their medication, 11 patients did not return diaries, 4 patients were excluded as noncompliant, and 5 patients withdrew without giving any reason. There were no serious adverse events."

Comment: incomplete data and dropouts addressed

Selective reporting (reporting bias)Low riskAll outcomes stated in the methods are mentioned in the results section

Other biasLow risk

Gaffey 1988

MethodsRandomised controlled trial


ParticipantsNumber randomised: 69 subjects, 34 in the intervention group and 35 in the placebo group

Setting: hotel rooms, Virginia, USA

Study period: not stated

Age: not reported (young adults)

Sex: male

Diagnostic criteria: volunteers whom after virus inoculation had clinical colds defined by a modification of the criteria established by (Jackson 1958)

Inclusion criteria: healthy young adult male volunteers with titers of neutralising antibody to rhinovirus type 39 in serum of < 1:2

Exclusion criteria: upper respiratory tract infection or fever of unknown origin within 1 week of the study; concurrent use of oral or intranasal medication; and histories of atopy, sinusitis, asthma, chronic rhinitis and chronic medical illness

Aetiology: experimental cold


InterventionsTreatment: ipratropium formulated in a buffered saline solution to a final concentration of 0.03%. Each spray delivers 20 micrograms, dose was 2 sprays per nostril 3/day. The total ipratropium doses were 80 micrograms per treatment

Control: a vehicle solution served as placebo

Both formulations were self administered under observation as 2 sprays per nostril 3 times daily for 5 days beginning 24 hours after virus challenge


OutcomesDeveloping infection and clinical cold, rhinorrhoea subjective score, weight of nasal discharge, number of paper tissue used and adverse effects


NotesFunding source: supported in part by grants from Boehringer Ingelheim Pharmaceuticals, Inc.

Conflict of interest: not stated

Calculated sample size: yes (but the number calculated was not stated)
Quote: "The sample size was calculated from nasal mucus weight data from an earlier study testing a similar drug to provide statistical power of 80% for detecting a reduction of 40% in mucus weights at an alpha value of 0.05."


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskQuote: "Volunteers were randomly assigned to either treatment or placebo groups by a table of random numbers"

Comment: probably done

Allocation concealment (selection bias)Low riskQuote: "Both formulations were supplied in consecutively numbered, identical-appearing metered-spray devices"

Comment: probably done

Blinding (performance bias and detection bias)
All outcomes
Low riskQuote: "Staff members responsible for recording clinical symptoms, collecting clinical samples, and weighing mucus were blind as to the treatment status of the volunteers."

Comment: probably done

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo missing data

Selective reporting (reporting bias)Low riskAll outcomes addressed in the introduction appear clearly in the results

Other biasUnclear riskQuote: "This work was supported in part by grants from Boehringer Ingelheim Pharmaceuticals, Inc"

Comment: it is unclear if the funding source did or did not have any role in developing the protocol, approving the final results or even the results. There is insufficient detail to judge whether it is or is not a source of bias

Hayden 1996

MethodsRandomised controlled trial


ParticipantsNumber randomised: 411 (only one was excluded from ITT; this was an untreated patient who was disqualified because of a history of frequent complications during upper respiratory infections)
IB group: 137, control group: 137, no treatment group: 137

Setting: out-patient (3 university student health services), USA

Study period: 1 November 1993 to 29 March 1994

Age: 12 to 79 years, mean age of all groups is 22 years

Sex: male and female

Diagnostic criteria: history of rhinorrhoea associated with a common cold for no more than 36 hours

Inclusion criteria: the rhinorrhoea had to be scored as at least moderate in severity (a score of 5 or more on a visual analogue scale) and the severity had to be confirmed by the recovery of at least 1.5 g of nasal discharge over a 1-hour baseline observation period

Exclusion criteria: participants with a history of asthma or chronic respiratory disease, allergic or perennial rhinitis, nasal polyps, seasonal allergic rhinitis with allergen in season, or frequent complications associated with upper respiratory infections (such as sinusitis or bronchitis). Pregnant and lactating women. Participants with a positive result on a streptococcal antigen screening test (Q-Test-Strep, Becton-Dickinson, Cockeysville, Maryland), signs of lower respiratory tract disease, or an oral temperature greater than 102°F were also excluded from participating

Aetiology: natural


InterventionsTreatment: IB nasal spray 0.06% in a buffered salt solution (2 sprays per nostril, administered with a metered pump spray bottle designed to deliver a total dose of 84 micrograms per nostril); 3 to 4/day for 4 days

Control: nasal spray, which contained the same excipients as the IB spray but did not contain IB; administered 3 to 4/day for 4 days

Third group: no treatment group


OutcomesPrimary end point for efficacy: patient's global assessment of overall improvement obtained on study days 1, 2 and 5

Secondary measures of efficacy included: quantitation of nasal discharge weights, subjective assessments of rhinorrhoea severity on the first 2 study days and assessment of the severity of cold symptoms made using the visual analogue scale on the evening of each of the first 4 study days

Other outcomes reported: adverse events


NotesFunding source: yes, supported in part by grants from Boehringer Ingelheim Pharmaceuticals, Inc"

Conflict of interest: not stated

Calculated sample size: yes
Quote: "The sample size for this trial was determined on the basis of global assessments that required the patients to choose one of four ordinal categories (much better, better, no difference, or worse) to describe the amelioration or lack of amelioration of their cold. By comparing the percentage of patients in the ipratropium group who chose either "much better" or "better" with the percentage of patients in the control group who chose these responses, we determined that a sample size of 130 patients per group would be sufficient to detect 20% differences in proportions ranging from 20% versus 40% to 70% versus 90% between the control and ipratropium groups, respectively, with a 90% power or greater (alpha = 0.05). The same sample size had a similar power to detect 20% differences in the mean visual analogue scale assessments of severity of rhinorrhoea (alpha = 0.05)."


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskQuote: "Patients who met the entrance criteria were randomly assigned by a computer-generated randomizations sequence to one of three groups..."

Comment: probably done

Allocation concealment (selection bias)Low riskQuote: "The ipratropium and control spray bottles were identical in appearance. To minimize unintentional bias in assigning patients to receive no treatment, empty bottles were used as place holders for these patients. The bottles were placed in sequence with the filled bottles and were labelled "Do Not Dispense to Patient."

Comment: probably done

Blinding (performance bias and detection bias)
All outcomes
Unclear riskQuote: "The treatments were administered under double-blind conditions; the untreated group was not blinded."

Comment: participants blinded, but insufficient information to judge about investigators

Incomplete outcome data (attrition bias)
All outcomes
Low riskQuote: "only one was excluded from ITT; this was an untreated patient who was disqualified because of a history of frequent complications during upper respiratory infections."

"Two ipratropium recipients were lost to follow-up (one on study day 2 and one on study day 5), but all patients completed the first 2 days of the trial and were included in the analysis."

Comment: no other missing data

Selective reporting (reporting bias)Low riskAll outcomes addressed in the methods appear clearly in the results

Other biasUnclear riskIt was supported in part by a grant from Boehringer Ingelheim pharmaceuticals; also 2 of the authors are affiliated with the company that manufactures the intervention studied. No further detail provided on what roles they had in approving the protocol, analysing data or approving the final draft

Østberg 1997

MethodsRandomised controlled trial


ParticipantsNumber enrolled: 50 participants, 26 in treatment group and 24 in control group

Setting: out-patient, Denmark

Study period: not stated

Age: mean 30.7 (range 20 to 55)

Sex: 33 women and 17 men

Diagnostic criteria: subjects felt confident that they had caught a cold and had suffered from rhinorrhoea and attacks of sneezing for less than 24 h (throat symptoms less than 36 h)

Inclusion criteria: were able to produce at least 0.2 ml of nasal secretion during a 15-min observation period, showed obvious signs of rhinitis during observation period (red nose, sneezing, discharge, blockage, rhinolalia) and gave informed consent to participate

Exclusion criteria: allergic disease, chronic or recurrent airway disease, or frequent complications to common colds (otitis media, sinusitis, bronchitis). Use of other medications

Aetiology: natural


InterventionsIntervention: IB as a micronised powder, was propelled by CFC gas (Freon) from a pressurised canister, equipped with a nasal adaptor. The dose was 2 puffs each of 100 micrograms IB in each nostril 4/day for 3 days

Control: placebo (no further details)


OutcomesNumber of sneezes and nose blowing, weight of nasal discharge, physical characteristics of secretions and side effects


NotesFunding source: unclear, coded aerosols were provided by Boehringer Ingelheim

Conflict of interest: not stated

Calculated sample size: not stated


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "The patients were allocated at random to treatment with IB or placebo"

Comment: insufficient information to judge

Allocation concealment (selection bias)Unclear riskInsufficient data

Blinding (performance bias and detection bias)
All outcomes
Low riskQuote: "The trial was performed as a double-blind, placebo-controlled, randomised study",

"Coded aerosols were provided by Boehringer Ingelheim", "..was carried out by two of the investigators before the code was broken."

Comment: probably done and maintained

Incomplete outcome data (attrition bias)
All outcomes
Low riskQuote: "All patients who entered the study completed the treatment and were included in the assessment of effects and side effects."

Comment: no missing data

Selective reporting (reporting bias)Low riskAll outcomes addressed in the methods are present in the results section

Other biasUnclear riskQuote: "Coded aerosols were provided by Boehringer Ingelheim"

Comment: no further details provided in regards to their involvement in the study or not

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Kim 2005Included a paediatric group of < 5 years, which was part of our exclusion criteria

Pitkäranta 1998The intervention group included the combination of IB + xylometazoline

 
Comparison 1. Ipratropium bromide versus placebo

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Adverse effects74463Odds Ratio (M-H, Random, 95% CI)2.09 [1.40, 3.11]

    1.1 Epistaxis
41078Odds Ratio (M-H, Random, 95% CI)3.21 [1.68, 6.13]

    1.2 Nasal dryness
61131Odds Ratio (M-H, Random, 95% CI)2.55 [1.50, 4.33]

    1.3 Eye dryness
169Odds Ratio (M-H, Random, 95% CI)3.18 [0.13, 80.79]

    1.4 Mouth dryness
4714Odds Ratio (M-H, Random, 95% CI)3.59 [1.38, 9.38]

    1.5 Nasal irritation
3383Odds Ratio (M-H, Random, 95% CI)0.77 [0.07, 8.00]

    1.6 Headache
3440Odds Ratio (M-H, Random, 95% CI)0.55 [0.23, 1.28]

    1.7 Tachycardia
2324Odds Ratio (M-H, Random, 95% CI)0.44 [0.04, 5.19]

    1.8 Blurred vision
2324Odds Ratio (M-H, Random, 95% CI)0.0 [0.0, 0.0]

 
Table 1. Change in severity of rhinorrhoea*

StudyChange in severity of rhinorrhoeaIB 0.12%/nostril (168 µg)IB 0.06%/nostril (84 µg)IB 0.03%/nostril (42 µg)PlaceboNo treatment

Diamond 1995Calculated change in the mean of the VAS from baseline for days 1 and 251.5%47.2%44.9%38.2%27.2%

Dockhorn 1992Improvement between the 2 groups was 22% more in the IB group for days 1 and 2 averagedN/AN/AN/A

Eccles 2007Calculated change in the mean of the VAS from baseline for day 1N/A36.4%N/A20.5%N/A

Hayden 1996Calculated change in the mean of the VAS from baseline for days 1 and 2N/A48.2%N/A36.3%N/A

 IB: ipratropium bromide
N/A: not applicable
µg: microgram
VAS: visual analogue scale
* This table is only to provide tabular presentation of the text under Effects of interventions. It is not meant for comparison among the four studies, as methods used for assessment varied among them.