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A Meta-analysis of Zinc Salts Lozenges and the Common Cold

A Meta-analysis of Zinc Salts Lozenges and the Common Cold Abstract Background: In the United States, the common cold has been estimated to cost more than $3.5 billion a year. Despite several randomized clinical trials, the effect of treating colds with zinc salts lozenges remains uncertain because of conflicting results. Objective: To conduct a meta-analysis of published randomized clinical trials on the use of zinc salts lozenges in colds using a random effects model. Results: Eight clinical trials of treating adults with zinc salts lozenges were identified. After excluding 2 studies that used nasal inoculation of rhinovirus, 6 trials were combined and analyzed. The summary odds ratio for the presence of any cold symptoms at 7 days was 0.50 (95% confidence interval, 0.19-1.29). Conclusion: Despite numerous randomized trials, the evidence for effectiveness of zinc salts lozenges in reducing the duration of common colds is still lacking.Arch Intern Med. 1997;157:2373-2376 References 1. Schappert SM. National ambulatory medical care survey: 1989 summary . Vital Health Stat 13. 1992;110:1-17. 2. Gwaltney JM, Hendley JO, Simon G, Jordan WS. Rhinovirus infections in an industrial population, I: the occurrence of illness . N Engl J Med. 1966;275:1261-1268.Crossref 3. Dingle JH, Bager GF, Jordan WS. Illness in the Home: Study of 25,000 Illnesses in a Group of Cleveland Families . Cleveland, Ohio: Western Reserve University Press; 1964. 4. Couch RB. The common cold: control? J Infect Dis. 1984;150:167-173.Crossref 5. Korant BD, Kauer JE, Butterworth BE. Zinc ions inhibit replication of rhinoviruses . Nature. 1974;248:588-590.Crossref 6. Korant BD, Butterworth BE. Inhibition by zinc of rhinovirus protein cleavage: interaction of zinc with capsid polypeptides . J Virol. 1976;18:298-306. 7. Kelly RW, Abel MH. Copper and zinc inhibit the metabolism of prostaglandin by the human uterus . Biol Reprod. 1983;28:883-889.Crossref 8. Novick SG, Godfrey JC, Godfrew MJ, Wilder HR. How does zinc modify the common cold? Med Hypotheses. 1996;46:295-302.Crossref 9. Geist FC, Bateman JA, Hayden FG. In vitro activity of zinc salts against human rhinoviruses . Antimicrob Agents Chemother. 1987;31:622-624.Crossref 10. Pasternack CA. A novel form of host defense: membrane protection by Ca2+ and Zn2 + . Biosci Rep. 1987;7:81-91.Crossref 11. Salas M, Kirchner H. Induction of interferon-gamma in human leukocyte cultures stimulated by Zn2+ . Clin Immunol Immunopathol. 1987;45:139-142.Crossref 12. Al-Nakib W, Higgins PG, Barrow I, Batstone G, Tyrrell DA. Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges . J Antimicrob Chemother. 1987;20:893-901.Crossref 13. Eby GA, Davis DR, Halcomb WW. Reduction in duration of common cold by zinc gluconate lozenges in a double-blind study . Antimicrob Agents Chemother. 1984: 25:20-24. 14. Godfrey JC, Conant Sloane B, Smith DS, Turco JH, Mercer N, Godfrey NJ. Zinc gluconate and the common cold: a controlled clinical study . J Int Med Res. 1992; 20:234-246. 15. Mossad SB, Macknin ML, Medendorp SV, Mason P. Zinc gluconate lozenges for treating the common cold: a randomized, double-blind, placebo-controlled study . Ann Intern Med. 1996;125:81-88.Crossref 16. Farr BM, Conner EM, Betts RF, et al. Two randomized controlled trials of zinc gluconate lozenge therapy of experimentally induced rhinovirus colds . Antimicrob Agents Chemother. 1987;31:1183-1187.Crossref 17. Douglas RM, Miles HB, Moore BW, Ryan P, Pinnock CB. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory infection in Australian adults . Antimicrob Agents Chemother. 1987;31:1263-1265.Crossref 18. Smith DS, Helzner EC, Nuttall CE, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections . Antimicrob Agents Chemother. 1989; 33:646-648.Crossref 19. Weismann K, Jakobsen JP, Weismann JE, et al. Zinc gluconate lozenges for common cold: a double-blind clinical trial . Dan Med Bull. 1990;37:279-291. 20. Chalmers T, Smith H, Blackburn B, et al. A method for assessing the quality of a randomized control trial . Controlled Clin Trials. 1981;2:31-49.Crossref 21. Wolf FM. Meta-Analysis: Quantitative Methods for Research Synthesis . Newbury Park, Calif: Sage Publications; 1986. 22. Peto R. Why do we need systematic overviews of randomized trials? Stat Med. 1987;6:233-240.Crossref 23. Petitti DB. Meta-Analysis, Decision Analysis and Cost-effectiveness Analysis: Methods for Quantitative Synthesis in Medicine . New York, NY: Oxford University Press; 1994. 24. Fleiss JL. The statistical basis of meta-analysis . Stat Methods Med Res. 1993; 2:121-145.Crossref 25. Farr BM, Gwaltney JM Jr, The problems of taste in placebo matching: an evaluation of zinc gluconate for the common cold. J Chronic Dis. 1987;40:875-879.Crossref 26. Potter YJ, Hart LL. Zinc lozenges for the common cold . Ann Pharmacother. 1993; 27:589-591. 27. Jackson GG, Dowling HF, Spiesman IG, Brand AV. Transmission of the common cold to volunteers under controlled conditions, I: the common cold as a clinical entity . Arch Intern Med. 1958;101:267-278.Crossref 28. Jennings LC, Dick EC. Transmission and control of rhinovirus colds . J Epidemiol. 1987;3:327-335. 29. Chalmers TC. Effects of ascorbic acid on the common cold . Am J Med. 1973; 48:532-536. 30. Godfrey JC. Zinc for the common cold . Antimicrob Agents Chemother. 1988;32:605-606.Crossref 31. Eby GA. Stability constants of zinc complexes affect common cold treatment results . Antimicrob Agents Chemother. 1988;32:606-607.Crossref 32. Zarembo JE, Godfrey JC, Godfrey NJ. Zinc (II) in saliva: determination of concentrations produced by different formulations of zinc gluconate lozenges containing common excipients . J Pharm Sci. 1992;81:128-130.Crossref 33. Farr BM, Hayden FG, Gwaltney JM. Zinc for the common cold . J Antimicrob Chemother. 1988;32:607. 34. Chandra RK. Excessive intake of zinc impairs immune responses . JAMA. 1984; 252:1443-1446.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

A Meta-analysis of Zinc Salts Lozenges and the Common Cold

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1997.00440410105012
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Abstract

Abstract Background: In the United States, the common cold has been estimated to cost more than $3.5 billion a year. Despite several randomized clinical trials, the effect of treating colds with zinc salts lozenges remains uncertain because of conflicting results. Objective: To conduct a meta-analysis of published randomized clinical trials on the use of zinc salts lozenges in colds using a random effects model. Results: Eight clinical trials of treating adults with zinc salts lozenges were identified. After excluding 2 studies that used nasal inoculation of rhinovirus, 6 trials were combined and analyzed. The summary odds ratio for the presence of any cold symptoms at 7 days was 0.50 (95% confidence interval, 0.19-1.29). Conclusion: Despite numerous randomized trials, the evidence for effectiveness of zinc salts lozenges in reducing the duration of common colds is still lacking.Arch Intern Med. 1997;157:2373-2376 References 1. Schappert SM. National ambulatory medical care survey: 1989 summary . Vital Health Stat 13. 1992;110:1-17. 2. Gwaltney JM, Hendley JO, Simon G, Jordan WS. Rhinovirus infections in an industrial population, I: the occurrence of illness . N Engl J Med. 1966;275:1261-1268.Crossref 3. Dingle JH, Bager GF, Jordan WS. Illness in the Home: Study of 25,000 Illnesses in a Group of Cleveland Families . Cleveland, Ohio: Western Reserve University Press; 1964. 4. Couch RB. The common cold: control? J Infect Dis. 1984;150:167-173.Crossref 5. Korant BD, Kauer JE, Butterworth BE. Zinc ions inhibit replication of rhinoviruses . Nature. 1974;248:588-590.Crossref 6. Korant BD, Butterworth BE. Inhibition by zinc of rhinovirus protein cleavage: interaction of zinc with capsid polypeptides . J Virol. 1976;18:298-306. 7. Kelly RW, Abel MH. Copper and zinc inhibit the metabolism of prostaglandin by the human uterus . Biol Reprod. 1983;28:883-889.Crossref 8. Novick SG, Godfrey JC, Godfrew MJ, Wilder HR. How does zinc modify the common cold? Med Hypotheses. 1996;46:295-302.Crossref 9. Geist FC, Bateman JA, Hayden FG. In vitro activity of zinc salts against human rhinoviruses . Antimicrob Agents Chemother. 1987;31:622-624.Crossref 10. Pasternack CA. A novel form of host defense: membrane protection by Ca2+ and Zn2 + . Biosci Rep. 1987;7:81-91.Crossref 11. Salas M, Kirchner H. Induction of interferon-gamma in human leukocyte cultures stimulated by Zn2+ . Clin Immunol Immunopathol. 1987;45:139-142.Crossref 12. Al-Nakib W, Higgins PG, Barrow I, Batstone G, Tyrrell DA. Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges . J Antimicrob Chemother. 1987;20:893-901.Crossref 13. Eby GA, Davis DR, Halcomb WW. Reduction in duration of common cold by zinc gluconate lozenges in a double-blind study . Antimicrob Agents Chemother. 1984: 25:20-24. 14. Godfrey JC, Conant Sloane B, Smith DS, Turco JH, Mercer N, Godfrey NJ. Zinc gluconate and the common cold: a controlled clinical study . J Int Med Res. 1992; 20:234-246. 15. Mossad SB, Macknin ML, Medendorp SV, Mason P. Zinc gluconate lozenges for treating the common cold: a randomized, double-blind, placebo-controlled study . Ann Intern Med. 1996;125:81-88.Crossref 16. Farr BM, Conner EM, Betts RF, et al. Two randomized controlled trials of zinc gluconate lozenge therapy of experimentally induced rhinovirus colds . Antimicrob Agents Chemother. 1987;31:1183-1187.Crossref 17. Douglas RM, Miles HB, Moore BW, Ryan P, Pinnock CB. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory infection in Australian adults . Antimicrob Agents Chemother. 1987;31:1263-1265.Crossref 18. Smith DS, Helzner EC, Nuttall CE, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections . Antimicrob Agents Chemother. 1989; 33:646-648.Crossref 19. Weismann K, Jakobsen JP, Weismann JE, et al. Zinc gluconate lozenges for common cold: a double-blind clinical trial . Dan Med Bull. 1990;37:279-291. 20. Chalmers T, Smith H, Blackburn B, et al. A method for assessing the quality of a randomized control trial . Controlled Clin Trials. 1981;2:31-49.Crossref 21. Wolf FM. Meta-Analysis: Quantitative Methods for Research Synthesis . Newbury Park, Calif: Sage Publications; 1986. 22. Peto R. Why do we need systematic overviews of randomized trials? Stat Med. 1987;6:233-240.Crossref 23. Petitti DB. Meta-Analysis, Decision Analysis and Cost-effectiveness Analysis: Methods for Quantitative Synthesis in Medicine . New York, NY: Oxford University Press; 1994. 24. Fleiss JL. The statistical basis of meta-analysis . Stat Methods Med Res. 1993; 2:121-145.Crossref 25. Farr BM, Gwaltney JM Jr, The problems of taste in placebo matching: an evaluation of zinc gluconate for the common cold. J Chronic Dis. 1987;40:875-879.Crossref 26. Potter YJ, Hart LL. Zinc lozenges for the common cold . Ann Pharmacother. 1993; 27:589-591. 27. Jackson GG, Dowling HF, Spiesman IG, Brand AV. Transmission of the common cold to volunteers under controlled conditions, I: the common cold as a clinical entity . Arch Intern Med. 1958;101:267-278.Crossref 28. Jennings LC, Dick EC. Transmission and control of rhinovirus colds . J Epidemiol. 1987;3:327-335. 29. Chalmers TC. Effects of ascorbic acid on the common cold . Am J Med. 1973; 48:532-536. 30. Godfrey JC. Zinc for the common cold . Antimicrob Agents Chemother. 1988;32:605-606.Crossref 31. Eby GA. Stability constants of zinc complexes affect common cold treatment results . Antimicrob Agents Chemother. 1988;32:606-607.Crossref 32. Zarembo JE, Godfrey JC, Godfrey NJ. Zinc (II) in saliva: determination of concentrations produced by different formulations of zinc gluconate lozenges containing common excipients . J Pharm Sci. 1992;81:128-130.Crossref 33. Farr BM, Hayden FG, Gwaltney JM. Zinc for the common cold . J Antimicrob Chemother. 1988;32:607. 34. Chandra RK. Excessive intake of zinc impairs immune responses . JAMA. 1984; 252:1443-1446.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 10, 1997

References