Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review

Abstract

Purpose Acute cough due to viral upper respiratory tract infections (URTIs) and bronchitis is a common reason for patients to seek medical care. Non-antibiotic over-the-counter cough medications such as ivy leaf extract are frequently used but their efficacy is uncertain. Our purpose was to update our previous systematic review and evaluate the effectiveness and tolerability of ivy leaf in the treatment of acute URTIs in adult and pediatric populations. Methods We searched MEDLINE, EMBASE, the Cochrane Library, and clinical trial registries from December 2009 to January 2020. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and observational studies (OSs) investigating ivy leaf mono- or combination preparations were included. Two independent reviewers assessed records for eligibility and risk of bias and performed data extraction. Results Six RCTs, 1 CCT, and 4 OSs were identified. Since the publication of our previous review, the number of RCTs has increased. All studies concluded that ivy leaf extract is an effective and safe option for the treatment of cough due to URTIs and bronchitis. Three RCTs reported a more rapid reduction in cough severity and/or frequency under ivy leaf treatment. The clinical significance of these effects appears to be minimal. No serious adverse effects were reported. The overall quality of reporting was low and the risk of bias was high. Conclusions Ivy leaf preparations are safe for use in cough due to acute URTIs and bronchitis. However, effects are minimal at best and of uncertain clinical importance.

Effect of the Administration of a Nutraceutical Supplement in Racehorses with Lower Airway Inflammation

“…In fact, some papers showed the efficacy of Allium sativum in the mitigation of inflammation and mucus production in a mouse model of human asthma [ 27 ], and in the reduction of tracheal mucus in equine asthmatic patients [ 28 ]. Furthermore, Thymus vulgaris showed effects in the modulation of mucus hypersecretion in vitro [ 29 ], while Hedera helix seems to play an important role in reducing cough [ 30 ] and to have a mucolytic activity similar to acetylcysteine [ 31 ] in human patients with bronchitis. Finally, Glycyrrhiza glabra represents one of the most used and effective compounds for asthma in Chinese traditional medicine, and it was effective in reducing ROS production, bronchial inflammation, and mucus production in a murine model of human asthma [ 32 , 33 ].…”

Akuter und chronischer Husten – Differenzialdiagnose und Behandlung

“…fehlend. Phytotherapeutika wie beispielsweise Thymian-Efeu-Präparate oder Myrtol zeigen in Studien begrenzte Effekte (schnellere Besserung von Hustenbeschwerden) 13 14 15 . Allerdings sind diese Medikamente erstens in der Regel vom Patienten selbst zu bezahlen, und zweitens kann die klinische Relevanz der Effekte kritisch diskutiert werden.…”

Ivy leaves extract EA 575 in the treatment of cough during acute respiratory tract infections: meta-analysis of double-blind, randomized, placebo-controlled trials

“…Today’s over-the-counter (OTC) market offers a wide range of antitussive agents and expectorants for symptomatic cough treatment even though the efficacy of many of these treatments is still a matter of debate, not least due to methodological issues of available studies 20 – 22 . Extracts from dried ivy leaves ( Hedera helix L.) are among the most widely used expectorants that act by improving mucus excretion.…”

“…A large number of interventional and non-interventional studies investigating the effects of ivy leaves extracts have been published. For EA 575, data from more than 65,000 patients are available from clinical trials and post-marketing research 22 , 28 . The results indicate that in patients with ARTIs, EA 575 reduces the frequency and duration of coughing, and thus also ameliorates the disease burden experienced by the patients subjectively.…”

“…The results indicate that in patients with ARTIs, EA 575 reduces the frequency and duration of coughing, and thus also ameliorates the disease burden experienced by the patients subjectively. The updated systematic review of Sierocinski et al 22 also includes evidence from two double-blind, randomized, placebo-controlled trials assessing the efficacy EA 575 in ARTIs 29 , 30 , which the authors identified as the only investigations of this type of an ivy leaves dry extract mono-preparation that complied with currently applicable scientific standards. However, the authors neither performed a meta-analysis of these trials, nor did they identify any other work that provided a quantitative synthesis of studies performed for ivy leaf extract preparations.…”