{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:01:47Z","timestamp":1768413707703,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007561","name":"Chiesi Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007561","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Inhaled corticosteroids have been proposed as treatment for acute COVID\u201019 infection in the community. We sought to determine the efficacy and safety of inhaled ciclesonide 320 mcg daily for 14\u2009days compared to placebo in reducing the time to first recovery from all symptoms within 28\u2009days of randomisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a two\u2010arm, double blind, placebo\u2010controlled, community\u2010based randomised trial. Participants received inhaled ciclesonide 320 mcg daily or matching placebo for 14\u2009days. The primary outcome was time to recovery of symptoms to day 28. An updated systematic review of all controlled trials of inhaled corticosteroids for acute COVID\u201019 was then undertaken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 189 people randomised and 185 completed treatment; 96% were COVID\u201019 vaccinated. No difference was seen in the time to first recovery using a proportional hazards analysis, recovery rate ratio 1.04 (95% CI; 0.77, 1.40). The median time to recovery with ciclesonide was 7\u2009days (95% CI 6\u20139), compared with placebo of 7\u2009days (95% CI 6\u20139),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.84. There were no significant differences in secondary outcomes, including time to sustained recovery and respiratory symptoms. The treatment was safe and well tolerated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a highly vaccinated (&gt;\u200990%) population exposed to Omicron variants of SARS\u2010CoV\u20102, the addition of inhaled ciclesonide had no effect on accelerating recovery from acute symptoms. These trial results and updated combined evidence of placebo\u2010controlled trials do not support the use of inhaled corticosteroids for the treatment of COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ACTRN12620000566932\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70125-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/resp.70125","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T07:00:21Z","timestamp":1759820421000},"page":"82-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inhaled Ciclesonide for Community\u2010Based\n                    <scp>COVID<\/scp>\n                    \u201019: A Placebo\u2010Controlled Randomised Trial"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5676-6126","authenticated-orcid":false,"given":"Peter","family":"Wark","sequence":"first","affiliation":[{"name":"School of Translational Medicine Monash University  Melbourne Australia"},{"name":"School of Medicine Health and Well Being University of Newcastle  New Lambton Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian C.","family":"Marschner","sequence":"additional","affiliation":[{"name":"University of Sydney NHMRC 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