Evidence map›Paper›PMID 41054293›Full record

Trial reportRespirology (Carlton, Vic.)2026

Inhaled Ciclesonide for Community-Based COVID-19: A Placebo-Controlled Randomised Trial.

Peter Wark, Ian C Marschner, Owen Hutchings, Gemma Blunt, Greg J Fox, Meg Jardine, Thomas Snelling, Arlen Wilcox, Emily Amico, Karen Allison and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Respirology (Carlton, Vic.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Peter WarkSchool of Translational Medicine, Monash University, Melbourne, Australia.ORCID 0000-0001-5676-6126
Ian C MarschnerUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Owen HutchingsRoyal Prince Alfred Hospital, Camperdown, Australia.
Gemma BluntUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Greg J FoxRoyal Prince Alfred Hospital, Camperdown, Australia.
Meg JardineUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Thomas SnellingUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Arlen WilcoxUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Emily AmicoSchool of Medicine Health and Well Being, University of Newcastle, New Lambton, Australia.
Karen AllisonUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Kate WilsonUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.ORCID 0000-0003-1886-4280
John SimesUniversity of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia.
Guy B MarksSchool of Medicine, University of New South Wales, Liverpool, Australia.ORCID 0000-0002-8976-8053

Funding

Chiesi pharmaceuticalsMinistry of Health, New South Wales Government
6 · The paper itself

Abstract

BACKGROUND AND

objectivesInhaled corticosteroids have been proposed as treatment for acute COVID-19 infection in the community. We sought to determine the efficacy and safety of inhaled ciclesonide 320 mcg daily for 14 days compared to placebo in reducing the time to first recovery from all symptoms within 28 days of randomisation.

methodsWe conducted a two-arm, double blind, placebo-controlled, community-based randomised trial. Participants received inhaled ciclesonide 320 mcg daily or matching placebo for 14 days. 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-19 was then undertaken.

resultsThere were 189 people randomised and 185 completed treatment; 96% were COVID-19 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 days (95% CI 6-9), compared with placebo of 7 days (95% CI 6-9), p = 0.84. There were no significant differences in secondary outcomes, including time to sustained recovery and respiratory symptoms. The treatment was safe and well tolerated.

conclusionIn a highly vaccinated (> 90%) population exposed to Omicron variants of SARS-CoV-2, the addition of inhaled ciclesonide had no effect on accelerating recovery from acute symptoms. These trial results and updated combined evidence of placebo-controlled trials do not support the use of inhaled corticosteroids for the treatment of COVID-19.

trial registrationACTRN12620000566932.

Indexed as

COVID-19COVID-19 Drug TreatmentPregnenedionesAdministration, InhalationAdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedSARS-CoV-2Treatment OutcomeciclesonidePregnenedionesCOVID‐19inhaled corticosteroidsSARS‐CoV2

Identifiers

PMID41054293
PMCPMC12783969

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.