Cargando…

Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND: Paracetamol and ibuprofen are the most commonly used medications for fever and pain management in children. While the efficacy appears similar with both drugs, there are contradictory findings related to adverse events. In particular, incidence of wheezing and asthma among children takin...

Descripción completa

Detalles Bibliográficos
Autores principales: Sherbash, Mohamed, Furuya-Kanamori, Luis, Nader, Joanne Daghfal, Thalib, Lukman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7087361/
https://www.ncbi.nlm.nih.gov/pubmed/32293369
http://dx.doi.org/10.1186/s12890-020-1102-5
_version_ 1783509323199021056
author Sherbash, Mohamed
Furuya-Kanamori, Luis
Nader, Joanne Daghfal
Thalib, Lukman
author_facet Sherbash, Mohamed
Furuya-Kanamori, Luis
Nader, Joanne Daghfal
Thalib, Lukman
author_sort Sherbash, Mohamed
collection PubMed
description BACKGROUND: Paracetamol and ibuprofen are the most commonly used medications for fever and pain management in children. While the efficacy appears similar with both drugs, there are contradictory findings related to adverse events. In particular, incidence of wheezing and asthma among children taking paracetamol compared to ibuprofen, remain unsettled. METHODS: We conducted a meta-analysis of randomized controlled trials (RCTs) that compared wheezing and asthma exacerbations in children taking paracetamol versus ibuprofen. A comprehensive search was conducted in five databases. RCTs reporting on cases of wheezing or asthma exacerbations in infants or children after the administration of paracetamol or ibuprofen were included. The pooled effect size was estimated using the Peto’s odds ratio. RESULTS: Five RCTs with 85,095 children were included in the analysis. The pooled estimate (OR 1.05; 95%CI 0.76–1.46) revealed no difference in the odds of developing asthma or presenting an exacerbation of asthma in children who received paracetamol compared to ibuprofen. When the analysis was restricted to RCTs that examined the incidence of asthma exacerbation or wheezing, the pooled estimate remained similar (OR 1.01; 95%CI 0.63–1.64). Additional bias adjusted quality effect sensitivity model yielded similar results (RR 1.03; 95%CI 0.84–1.28). CONCLUSION: Although, Ibuprofen and paracetamol appear to have similar tolerance and safety profiles in terms of incidence of asthma exacerbations in children, we suggest high quality trials with clear definition of asthma outcomes after receiving ibuprofen or paracetamol at varying doses with longer follow-up are warranted for any conclusive finding.
format Online
Article
Text
id pubmed-7087361
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70873612020-03-24 Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials Sherbash, Mohamed Furuya-Kanamori, Luis Nader, Joanne Daghfal Thalib, Lukman BMC Pulm Med Research Article BACKGROUND: Paracetamol and ibuprofen are the most commonly used medications for fever and pain management in children. While the efficacy appears similar with both drugs, there are contradictory findings related to adverse events. In particular, incidence of wheezing and asthma among children taking paracetamol compared to ibuprofen, remain unsettled. METHODS: We conducted a meta-analysis of randomized controlled trials (RCTs) that compared wheezing and asthma exacerbations in children taking paracetamol versus ibuprofen. A comprehensive search was conducted in five databases. RCTs reporting on cases of wheezing or asthma exacerbations in infants or children after the administration of paracetamol or ibuprofen were included. The pooled effect size was estimated using the Peto’s odds ratio. RESULTS: Five RCTs with 85,095 children were included in the analysis. The pooled estimate (OR 1.05; 95%CI 0.76–1.46) revealed no difference in the odds of developing asthma or presenting an exacerbation of asthma in children who received paracetamol compared to ibuprofen. When the analysis was restricted to RCTs that examined the incidence of asthma exacerbation or wheezing, the pooled estimate remained similar (OR 1.01; 95%CI 0.63–1.64). Additional bias adjusted quality effect sensitivity model yielded similar results (RR 1.03; 95%CI 0.84–1.28). CONCLUSION: Although, Ibuprofen and paracetamol appear to have similar tolerance and safety profiles in terms of incidence of asthma exacerbations in children, we suggest high quality trials with clear definition of asthma outcomes after receiving ibuprofen or paracetamol at varying doses with longer follow-up are warranted for any conclusive finding. BioMed Central 2020-03-23 /pmc/articles/PMC7087361/ /pubmed/32293369 http://dx.doi.org/10.1186/s12890-020-1102-5 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sherbash, Mohamed
Furuya-Kanamori, Luis
Nader, Joanne Daghfal
Thalib, Lukman
Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title_full Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title_fullStr Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title_full_unstemmed Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title_short Risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
title_sort risk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: a systematic review and meta-analysis of randomised controlled trials
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7087361/
https://www.ncbi.nlm.nih.gov/pubmed/32293369
http://dx.doi.org/10.1186/s12890-020-1102-5
work_keys_str_mv AT sherbashmohamed riskofwheezingandasthmaexacerbationinchildrentreatedwithparacetamolversusibuprofenasystematicreviewandmetaanalysisofrandomisedcontrolledtrials
AT furuyakanamoriluis riskofwheezingandasthmaexacerbationinchildrentreatedwithparacetamolversusibuprofenasystematicreviewandmetaanalysisofrandomisedcontrolledtrials
AT naderjoannedaghfal riskofwheezingandasthmaexacerbationinchildrentreatedwithparacetamolversusibuprofenasystematicreviewandmetaanalysisofrandomisedcontrolledtrials
AT thaliblukman riskofwheezingandasthmaexacerbationinchildrentreatedwithparacetamolversusibuprofenasystematicreviewandmetaanalysisofrandomisedcontrolledtrials