Dry extract of ivy leaves in the treatment of cough during acute respiratory tract infections
Acute respiratory tract infections are the most common diseases in primary care. It is estimated that 90 percent of such infections have a viral etiology and therefore antibiotic treatment, although quite commonly prescribed, is usually not indicated.
On average, adults suffer 2-3 acute respiratory tract infections per year. Although most UTIs are trivial and self-limiting, they can nevertheless cause significant suffering and impairment of daily activities, including reduced productivity or absence from work. Their economic impact through direct and indirect costs is therefore enormous.
Cough is one of the main symptoms of ARTIs such as acute bronchitis or the common cold. Together with mucociliary clearance, it represents an important defense mechanism of the body in response to irritating stimuli of nerve endings located in the mucosa of the first airways.
In healthy individuals, mucus traps inhaled particles while mucociliary clearance continuously drains the mucus produced, thus minimizing contact of external agents with the lung epithelium. In ARTI, cough can be unproductive (dry, no excretion) or productive (moist, mucus expectoration). A productive cough should not be suppressed as it allows evacuation of mucus from the bronchi.
Extracts of the dried leaves of ivy ( Hedera helix L.) are among the most widely used expectorants that act by improving mucus excretion and have been used successfully to treat acute cough, and data from well-controlled studies are accumulating.
The research presents a meta-analysis of two double-blind, randomized, placebo-controlled trials.
Patients with acute respiratory tract infection (ARTI) received ivy leaf dry extract (n = 228) or placebo (n = 162) for 7 days, followed by a 7-day period without treatment. The main efficacy outcome was the Bronchitis Severity Score (BSS).
Meta-analyses of individual patient data were performed using mixed models for repeated measures, analysis of covariance, and logistic ordinal regression. Significant differences in Bronchitis Severity Score between ivy leaf dry extract and placebo occurred as early as 2 days and increased until the end of treatment, with Bronchitis Severity Score reductions of 8.6 ± 0.2 and 6.2 ± 0.2 (marginal mean ± SEM; p < 0.001).
The score reduction for placebo after 7 days was comparable to that for ivy leaf dry extract after 4 days. In the group taking ivy leaf dry extract , the percentage of patients without cough was 18.1% at the end of treatment and 56.2% at the end of follow-up, compared with 9.3% and 25.6% for placebo, respectively.
The rates of adverse events for taking ivy leaf dry extract and placebo were comparable. Ivy leaf dry extract effectively reduced the intensity of acute cough associated with acute respiratory tract infections and led to significant acceleration of recovery.
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Source: Völp A, Schmitz J, Bulitta M, Raskopf E, Acikel C, Mösges R. Ivy leaves extract EA 575 in the treatment of cough during acute respiratory tract infections: meta-analysis of double-blind, randomized, placebo-controlled trials. Sci Rep. November 2022;12(1):20041. doi:10.1038/s41598-022-24393-1.
