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Persistent COVID-19 parosmia and olfactory loss post olfactory training: randomized clinical trial comparing central and peripheral-acting therapeutics

Cantone E, D'Ascanio L, De Luca P, Roccamatisi D, La Mantia I, Brenner MJ, Di Stadio A. Eur Arch Otorhinolaryngol. 2024;281(7):3671-3678.

Randomised controlled trialHumansWith luteolin; alpha-lipoic acid in two arms

This study tested palmitoylethanolamide together with luteolin; alpha-lipoic acid in two arms. Its results cannot be assigned to palmitoylethanolamide alone. More combination studies.

Design
Randomised controlled trial
Subjects
120 adults (18 to 60) with persistent smell loss and parosmia after COVID-19 that had not resolved with earlier olfactory training; 89 analysed after 31 dropped out (17 PEA-luteolin, 21 alpha-lipoic acid, 28 both, 23 olfactory training alone)
Dose used in the study
One sachet daily of ultramicronised PEA 700 mg plus luteolin 70 mg (Glialia, Epitech); alpha-lipoic acid 800 mg daily; or both; all groups did daily olfactory training
Duration
6 months
What was measured
Sniffin' Sticks TDI score and a parosmia questionnaire at baseline and 6 months; assessors blinded to treatment

What the authors reported

TDI rose from 21.8 to 29.7 in the PEA-luteolin group and from 19.6 to 27.5 in the combination group (both p < 0.01). The alpha-lipoic acid group and the training-only group did not change significantly. Parosmia resolved in 96 percent of the combination group, 65 percent of controls, 53 percent of the PEA-luteolin group and 29 percent of the alpha-lipoic acid group. All regimens were well tolerated.

Limits of this study

Almost 30 percent dropped out, unevenly across groups (13 of 30 in the PEA-luteolin arm). Small groups after attrition. No placebo; the control arm had training only, and patients were not blinded. Baseline smell scores and ages differed between groups. Single centre. The parosmia result does not follow the TDI result: the training-only group had a higher parosmia resolution rate than the PEA-luteolin group. Authors report no conflicts and no specific funding; the product is a commercial Epitech sachet.

Source

doi:10.1007/s00405-024-08548-6

Entry checked against the full text (open access PDF), supplied by Devlin on 2026-09-21. The dose shown is the dose the researchers used. It is not a recommendation. How to read this page.