Asked by Anonymous
Corticosteroids inhibit transcription of proinflammatory mediators in human airway endothelial cells which cause pharyngeal inflammation and ultimately symptoms of pain. Corticosteroids are beneficial in other upper respiratory tract infections such as acute sinusitis, croup, and infectious mononucleosis. Corticosteroids would offer similar symptomatic relief from sore throat because of their anti-inflammatory effects, and undertook a systematic review to examine the effect of systemic corticosteroids on adults and children with sore throat.
Reference: Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009 Aug 6;339:b2976. doi: 10.1136/bmj.b2976. Erratum in: BMJ. 2010;340. doi: 10.1136/bmj.c692. PMID: 19661138; PMCID: PMC2722696.
In addition to any effect of antibiotics and analgesia, corticosteroids increased the likelihood of complete resolution of pain at 24 hours by 2.40 times (risk ratio (RR) 2.4, 95% confidence interval (CI) 1.29 to 4.47; P = 0.006; I² = 67%; high‐certainty evidence) and at 48 hours by 1.5 times (RR 1.50, 95% CI 1.27 to 1.76; P < 0.001; I² = 0%; high‐certainty evidence). Five people need to be treated to prevent one person continuing to experience pain at 24 hours. Corticosteroids also reduced the mean time to onset of pain relief and the mean time to complete resolution of pain by 6 and 11.6 hours, respectively, although significant heterogeneity was present (moderate‐certainty evidence). At 24 hours, pain (assessed by visual analogue scales) was reduced by an additional 10.6% by corticosteroids (moderate‐certainty evidence). No differences were reported in recurrence/relapse rates, days missed from work or school, or adverse events for participants taking corticosteroids compared to placebo.
Reference: de Cassan S, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ, Hayward G. Corticosteroids as standalone or add-on treatment for sore throat. Cochrane Database Syst Rev. 2020 May 1;5(5):CD008268. doi: 10.1002/14651858.CD008268.pub3. PMID: 32356360; PMCID: PMC7193118.
