Is a 25-mg ibuprofen throat lozenge effective in reducing sore throat pain in adults?

Low-dose (25-mg) ibuprofen throat lozenges are more effective than placebo in reducing sore throat pain in adults for up to 24 hours. (LOE = 1b-)

Bouroubi A, Donazzolo Y, Donath F, et al. Pain relief of sore throat with a new anti-inflammatory throat lozenge, ibuprofen 25 mg: A randomised, double-blind, placebo-controlled, international phase III study. Int J Clin Pract 2017;71:e12961.  [PMID:28869722]

Randomized controlled trial (double-blinded)

Industry

Uncertain

Outpatient (primary care)

Oral ibuprofen, 400 mg to 800 mg, is effective for sore throat pain, but the efficacy of a low-dose 25-mg ibuprofen throat lozenge was uncertain. These investigators identified adults, 18 years or older, who presented for an acute sore throat of 72 hours or less and a pain score on swallowing of at least 60 mm on a 0 to 100 mm visual analogue throat pain intensity scale. Eligible patients (N = 385) randomly received (uncertain allocation concealment) either ibuprofen 25 mg or matched placebo lozenge. Patients were instructed to suck one lozenge slowly until dissolution as needed for pain; up to six lozenges daily, with a minimal interval of at least 2 hours between lozenges. No other topical or systemic pain medications were allowed. Patients masked to treatment group assignment self-reported pain scores after every dose for up to 4 days. Complete follow-up occurred for 96.9% of patients for 4 days. Using intention-to-treat analysis, 33% and 50% pain-relief response rates up to 45 minutes after the first dose were significantly higher in the ibuprofen group than in the placebo group (number needed to treat = 8.0 and 11.5, respectively). Pain relief was also significantly higher for ibuprofen than placebo on the evening of the first day, but the differences in pain relief scores were no longer significant from day 2 onward.