Table 1.

Characteristics of prevention and treatment studies

Study	Country/ date/ setting	Participants analyzed; age; gender; baseline symptoms	Duration of study	Intervention	Control	Outcomes Measured	Safety Evaluation	Sponsor
Prevention of the common cold with elderberry
Tiralongo 2016 [33]	Australia/ 2013–14/ outpatient	N = 312; mean 51 (sd 16) years; 106 (34%) men; participants were in good general health and planning to travel overseas	15–16 days	Capsule with 300 mg proprietary elderberry extract taken 2–3 times/day	Placebo capsule	Proportion developing a cold, number of cold episode days, assessment of eight specific cold symptoms on a 0–4 scale (Jackson scale), quality of life, use of concomitant medication or therapy.	Although some minor adverse events were mentioned, assessment was not described.	Iprona AG, Italy.
Treatment of influenza with elderberry
Kong 2009 [35]	China/ 2009/ outpatient	N = 64; mean 40 years (range 20–59); 34 (53%) men; symptoms of influenza for <24 h	2 days	Lozenge with 175 mg proprietary elderberry extract taken 4 times/day	Placebo lozenge	Percentage improving from baseline symptoms of headache, nasal congestion, muscle aches, coughing, mucus discharge or fever, and mean VAS status for each symptom.	No mention of specific ascertainment however lack of side effects in the elderberry group was mentioned.	HerbalScience Singapore Pte. Ltd.
Zakay-Rones 2004 [10]	Israel/ 1999–2000/ outpatient	N = 60; mean 30 (2.9) years; 33 (55%) men; symptoms of influenza for a mean of 27 h	5 days	15 ml syrup with 38% proprietary elderberry extract (Sambucol) taken 4 times/day	Placebo syrup	Mean VAS status for global well-being and for six symptoms.	Participants were asked if they had any problem with sedation.	Razei Bar, Jerusalem, Israel
Zakay-Rones 1995 [34]	Israel/ not reported/ outpatient	N = 27; range 5–56 years; 18 (67%) men; symptoms of influenza for <24 h	3 days	1 tablespoon syrup with proprietary elderberry extract (Sambucol) taken 2 times/day (children) or 4 times/day (adults)	Placebo syrup	Proportion with complete cure and with improvement in specific symptoms. Overall duration of illness and mean number of days for seven symptoms.	Prior to study 35 persons received 4 tablespoons Sambucol daily for 3 days and no side effects were recorded.	Not reported
Treatment of influenza with elderberry and echinacea
Rauš 2015 [36]	Czech Republic/ 2011–13/ outpatient	N = 420; mean 37.2 (sd 13.5) years; 210 (50%) men; symptoms of influenza for ≤48 h	10 days	5 ml Echinaforce Hotdrink (combines echinacea and elderberry) taken 3–5 times/day (+ oseltamivir placebo taken 2 times/day)	Tamiflu taken 2 times/day (+  5 ml Echinaforce Hotdrink placebo taken 3–5 times/day)	Proportion recovered from symptoms, proportion with complications, severity of nine symptoms, sleep disturbance, return to normal activity, body temperature, use of rescue medication, health care contacts, need for antibiotics, hospitalization, and tolerability	Participants were asked whether they experienced any unusual or unexpected symptoms in addition to their influenza symptoms.	A. Vogel Bioforce AG, Roggwil, Switzerland