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Review
. 2024 Aug 25;16(8):e67740.
doi: 10.7759/cureus.67740. eCollection 2024 Aug.

Efficacy of Corticosteroids for Sore Throat Management in Adults: A Systematic Review and Meta-Analysis of Randomized Trials

Saad Alqahtani  1 , Tarfah Rashed I Alsharidi  2 , Mohammed A Alelaiwi  3 , Lama M Albelowi  4 , Abdulaziz Saeed Alserhani  5 , Ziyad A Alhosan  6 , Rema M Alhazmi  4 , Mohammed A Alaithan  7 , Abdullah O Almutairi  8 , Lama Alqahtani  9 , Abdullah S Alhammad  10 , Hotaf F Aljahdali  11 , Faten Althomali  12 , Maryam A Basalamah  13
Affiliations
Review

Efficacy of Corticosteroids for Sore Throat Management in Adults: A Systematic Review and Meta-Analysis of Randomized Trials

Saad Alqahtani et al. Cureus. .

Abstract

Sore throat (acute pharyngitis) is among the most common complaints among adults and is a reason for seeking healthcare globally. Antibiotics are widely used among patients with infectious sore throat. Previous research has indicated that corticosteroids could offer an alternative symptomatic treatment for sore throats. To estimate the corticosteroid efficacy as an additional therapy for sore throat adult patients, the literature search included PubMed, Medline, OVID, Cochrane CENTRAL, and Scopus for articles published until July 1st, 2024. The outcomes included the onset of pain relief (average time), complete resolution of pain (average time), absolute reduction of pain at 24 and 48 hours, requirement of antibiotics, and adverse effects related to treatment. Standardized mean difference (SMD) and risk difference were used to report numerical and dichotomous results. Five studies were included. Among the five included studies, corticosteroids showed significant effectiveness in resolving pain at 24 hours (average risk difference: 0.2200, 95% CI: 0.0500 to 0.3899, p = 0.0112) but with notable heterogeneity (I² = 82.4255%). At 48 hours, the benefit was not statistically significant (average risk difference: 0.4063, 95% CI: -0.1857 to 0.9984, p = 0.1786, I² = 98.9219%). Corticosteroids also decreased the average time to onset of pain relief (average SMD: -0.6590, 95% CI: -1.2857 to -0.0323, p = 0.0393, I² = 89.7914%), although with high heterogeneity. Other findings indicated a possible reduction in antibiotic use and fewer days missed from work. Adverse effects were minimal and occurred at similar rates in both corticosteroid and placebo arms. Corticosteroids can decrease pain intensity and duration in adults with acute sore throats. However, significant heterogeneity among studies and methodological limitations render the overall evidence inconclusive. While some studies noted reduced antibiotic use and lower symptom recurrence, high-quality RCTs are needed to address these limitations and provide more definitive guidelines for corticosteroid use in treating acute pharyngitis.

Keywords: clinical trials; corticosteroids; meta-analysis; pharyngitis; sore throat.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Selection of studies in the review of corticosteroids for the treatment of sore throat in adults
Figure 2
Figure 2. Traffic light plot
Figure 3
Figure 3. Summary of the overall ROB
ROB, risk of bias
Figure 4
Figure 4. Risk difference for complete resolution of pain at 24 hours for corticosteroid vs. placebo groups in the review of the treatment of sore throat
Pooled analysis calculated by DerSimonian-Laird random effects model.
Figure 5
Figure 5. Risk difference for complete resolution of pain at 48 hours for corticosteroid vs. placebo groups in the review of the treatment of sore throat
Figure 6
Figure 6. The weighted mean difference in the mean time to onset of pain relief (hours) between corticosteroids and placebo groups in the review of the treatment of sore throat
Pooled analysis calculated by DerSimonian-Laird random effects model.
Figure 7
Figure 7. Weighted mean difference in the mean time to complete resolution of pain (hours) between corticosteroids and placebo groups in the review of the treatment of sore throat
Pooled analysis calculated by DerSimonian-Laird random effects model.
Figure 8
Figure 8. Weighted mean difference in an absolute reduction of pain at 24 hours (0-10; 0 = no pain, 10 = maximum pain) between corticosteroids and placebo groups in the review of the treatment of sore throat
See this image and copyright information in PMC

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