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Research

Corticosteroids for pain relief in sore throat: systematic review and meta-analysis

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2976 (Published 06 August 2009) Cite this as: BMJ 2009;339:b2976

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Erratum

Sir, It was interesting to read the meta-analysis and systematic
review on the use of corticosteroids for pain relief in sore throat. I
would like to point out an error in this article in figure 4 (Effect of
corticosteroids on mean time to onset of pain relief analysed by subgroup
using meta-regression.), where the statistical values [(I2, Trials (n),
Patients(n), Interaction, Weighted mean difference (random)(95% CI)] for
bacterial pathogen positive and bacterial pathogen negative cases have
been interchanged. This will become more apparent if you read the second
paragraph under the subheading ‘Mean time to onset of pain relief' in the
results section.

Competing interests:
None declared

Competing interests: No competing interests

21 January 2010
Prince Cheriyan Modayil
SpR in ENT
Irfan Syed
Royal devon & exeter Hospital, EX2 5DS

Giving a corticosteroid (singular) for sore throat

The title and text of this review use only the plural
"corticosteroids": but of course each patient in the trials included
received only one corticosteroid. Use of the plural suggests from the
start that differences between corticosteroids are irrelevant or at least
unimportant, but the paper does not consider this point - it should.

Six of the 8 trials reviewed used dexamethasone, one betamethasone,
one prednisone. What differences might have been looked for between the
effects of these three drugs? What did the trial reports state about
adverse events? Seemingly only Kidman et al [w5] noted any. The reviewers
should surely have remarked on this inadequacy.

They also don't say openly what they themselves would now do for a
patient with a painful sore throat; I suppose they would favour a single
oral dose of dexamethasone - while virtuously waiting for more evidence
and 'generalisability'. But the question doesn't seem quite important
enough for trials to be funded in Europe.
How were the eight reviewed trials funded?

Competing interests:
None declared

Competing interests: No competing interests

30 August 2009
Andrew Herxheimer
clinical pharmacologist
London N3 2NL
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