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. 2021 Aug;77(8):1113-1122.
doi: 10.1007/s00228-021-03090-4. Epub 2021 Feb 1.

Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review

Elizabeth Sierocinski  1 , Felix Holzinger  2 , Jean-François Chenot  3
Affiliations

Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review

Elizabeth Sierocinski et al. Eur J Clin Pharmacol. 2021 Aug.

Abstract

Purpose: Acute cough due to viral upper respiratory tract infections (URTIs) and bronchitis is a common reason for patients to seek medical care. Non-antibiotic over-the-counter cough medications such as ivy leaf extract are frequently used but their efficacy is uncertain. Our purpose was to update our previous systematic review and evaluate the effectiveness and tolerability of ivy leaf in the treatment of acute URTIs in adult and pediatric populations.

Methods: We searched MEDLINE, EMBASE, the Cochrane Library, and clinical trial registries from December 2009 to January 2020. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and observational studies (OSs) investigating ivy leaf mono- or combination preparations were included. Two independent reviewers assessed records for eligibility and risk of bias and performed data extraction.

Results: Six RCTs, 1 CCT, and 4 OSs were identified. Since the publication of our previous review, the number of RCTs has increased. All studies concluded that ivy leaf extract is an effective and safe option for the treatment of cough due to URTIs and bronchitis. Three RCTs reported a more rapid reduction in cough severity and/or frequency under ivy leaf treatment. The clinical significance of these effects appears to be minimal. No serious adverse effects were reported. The overall quality of reporting was low and the risk of bias was high.

Conclusions: Ivy leaf preparations are safe for use in cough due to acute URTIs and bronchitis. However, effects are minimal at best and of uncertain clinical importance.

Keywords: Acute cough; Bronchitis; Hedera helix; Ivy leaf extract.

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Conflict of interest statement

FH reports co-authorship of an evidence-based clinical guideline on the management of cough published by the German College of General Practitioners and Family Physicians. JFC and ES have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Study selection process
Fig. 2
Fig. 2
Cochrane risk of bias assessment for a) RCTs, based on five domains and ranging from low to high; b) non-randomized studies, based on seven domains and ranging from low to critical
Fig. 3
Fig. 3
Five heterogeneous studies reporting cough severity via the Bronchitis Severity Scale (BSS) in four cases and a modified BSS (mBSS, wheezing instead of sputum assessed) in one case. Intervention groups are represented by a diamond shape and placebo groups by a circle. A combined circle and diamond shape depicts the BSS for a noninferiority study which combined data for the intervention and comparator groups. The populations of non-randomized studies are represented by squares; text within the squares indicates which comedication was allowed
See this image and copyright information in PMC

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