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 Table of Contents  
EVIDENCE-BASED MEDICINE
Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 61-62

Acetaminophen and asthma-related complications in children (acetaminophen vs. ibuprofen in children with asthma trial): A summary


Assistant Professor, Department of Biochemistry, CMC Vellore, Tamil Nadu, India

Date of Web Publication17-Feb-2017

Correspondence Address:
R Anand
Assistant Professor, Department of Biochemistry, CMC Vellore, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_9_17

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How to cite this article:
Anand R. Acetaminophen and asthma-related complications in children (acetaminophen vs. ibuprofen in children with asthma trial): A summary. Curr Med Issues 2017;15:61-2

How to cite this URL:
Anand R. Acetaminophen and asthma-related complications in children (acetaminophen vs. ibuprofen in children with asthma trial): A summary. Curr Med Issues [serial online] 2017 [cited 2019 Nov 12];15:61-2. Available from: http://www.cmijournal.org/text.asp?2017/15/1/61/200315

Clinical Question: Which artemisinin.based combination therapy is effective and safe in pregnant women with malaria?
Authorsf conclusion: As an antipyretic agent in children suffering from mild persistent asthma, use of acetaminophen is not associated with increased incidence of exacerbations when compared with ibuprofen



  Introduction Top


Acetaminophen is one of the most common antipyretic agents used. Epidemiologic studies have shown an association between use of acetaminophen as antipyretic agent and increased incidence of asthma-related complications in pediatric age group.[1] Despite a lack of well-conducted studies in this area, there has been a debate if acetaminophen should be avoided in children.[1],[2] The study investigators sought to address this question in comparison with ibuprofen in mild persistent asthma.

The antipyretic component of the trial was called Acetaminophen versus Ibuprofen in Children with Asthma trial. Acetaminophen suspension (160 mg/5 ml) and ibuprofen suspension (100 mg/5 ml) in customized identical packages were provided to caregivers. Caregivers were unaware of the treatment arm their children were in. The quantity of trial medication, diaries and questionnaires were used to monitor the reason for drug use. The primary outcome was the number of asthma exacerbations that led to treatment with systemic glucocorticoids per participant.




  Results Top


  • It was seen that the use of antipyretics was, in general, associated with an increased incidence in asthma exacerbations (P < 0.001)
  • In the acetaminophen group, 49% of participants had at least one asthma exacerbation, and 21% had at least two, as compared with 47% and 24%, respectively, in the ibuprofen group
  • However, there were no differences in number of episodes of asthma exacerbations between the two groups, with a mean of 0.81 per participant with acetaminophen and 0.87 per participant with ibuprofen over 46 weeks of follow-up
  • Relative rate of asthma exacerbations in the acetaminophen group versus the ibuprofen group was 0.94 (95% confidence interval: 0.69–1.28; P = 0.67)
  • No significant differences were noted in a number of asthma controlled days, use of unscheduled healthcare or rescue albuterol between both arms.



  Discussion Top


The results of this study are in contrast to an earlier published trial in this area which noted an increase in unscheduled health care.[5] However, it should be noted that their findings were obtained during a post hoc analysis. One of the limitations of the study is that the participants only had mild persistent asthma. Hence, the results may not be directly applicable to other clinical categories of asthma.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Beasley RW, Clayton TO, Crane J, Lai CK, Montefort SR, Mutius EV, et al. Acetaminophen use and risk of asthma, rhinoconjunctivitis, and eczema in adolescents: International study of asthma and allergies in childhood phase three. Am J Respir Crit Care Med 2011;183:171-8.  Back to cited text no. 1
    
2.
McBride JT. The association of acetaminophen and asthma prevalence and severity. Pediatrics 2011;128:1181-5.  Back to cited text no. 2
    
3.
National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-summary report 2007. J Allergy Clin Immunol 2007;120 5 Suppl: S94-138.  Back to cited text no. 3
    
4.
Sheehan WJ, Mauger DT, Paul IM, Moy JN, Boehmer SJ, Szefler SJ, et al. Acetaminophen versus ibuprofen in young children with mild persistent asthma. N Engl J Med 2016;375:619-30.  Back to cited text no. 4
    
5.
Lesko SM, Louik C, Vezina RM, Mitchell AA. Asthma morbidity after the short-term use of ibuprofen in children. Pediatrics 2002;109:E20.  Back to cited text no. 5
    




 

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Introduction
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