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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; Daghfal Nader, Joanne; Thalib, Lukman

Description

//Background:Paracetamol and ibuprofen are the most commonly used medications for fever and painmanagement in children. While the efficacy appears similar with both drugs, there are contradictory findings relatedto adverse events. In particular, incidence of wheezing and asthma among children taking paracetamol comparedto ibuprofen, remain unsettled. //Methods:We conducted a meta-analysis of randomized controlled trials (RCTs) that compared wheezing andasthma exacerbations in children taking...[Show more]

dc.contributor.authorSherbash, Mohamed
dc.contributor.authorFuruya-Kanamori, Luis
dc.contributor.authorDaghfal Nader, Joanne
dc.contributor.authorThalib, Lukman
dc.date.accessioned2020-11-12T02:53:44Z
dc.date.available2020-11-12T02:53:44Z
dc.identifier.issn1471-2466
dc.identifier.urihttp://hdl.handle.net/1885/216056
dc.description.abstract//Background:Paracetamol and ibuprofen are the most commonly used medications for fever and painmanagement in children. While the efficacy appears similar with both drugs, there are contradictory findings relatedto adverse events. In particular, incidence of wheezing and asthma among children taking paracetamol comparedto ibuprofen, remain unsettled. //Methods:We conducted a meta-analysis of randomized controlled trials (RCTs) that compared wheezing andasthma exacerbations in children taking paracetamol versus ibuprofen. A comprehensive search was conducted infive databases. RCTs reporting on cases of wheezing or asthma exacerbations in infants or children after theadministration 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 childrenwho received paracetamol compared to ibuprofen. When the analysis was restricted to RCTs that examined theincidence 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 ofincidence of asthma exacerbations in children, we suggest high quality trials with clear definition of asthmaoutcomes after receiving ibuprofen or paracetamol at varying doses with longer follow-up are warranted for anyconclusive finding
dc.description.sponsorshipThe publication of this article was funded by the Qatar National Library.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central
dc.rights© 2020 The Authors
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Pulmonary Medicine
dc.subjectParacetamol
dc.subjectAcetaminophen
dc.subjectIbuprofen
dc.subjectWheezing
dc.subjectAsthma
dc.subjectMeta-analysis
dc.titleRisk of wheezing and asthma exacerbation in children treated with paracetamol versus ibuprofen: A systematic review and meta-analysis of randomised controlled trials
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume20
dcterms.dateAccepted2020-02-28
dc.date.issued2020-03-23
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationa383154xPUB11203
local.publisher.urlhttps://bmcpulmmed.biomedcentral.com/
local.type.statusPublished Version
local.contributor.affiliationSherbash, Mohamed, Hamad Medical Corporation
local.contributor.affiliationFuruya Kanamori, Luis, College of Health and Medicine, ANU
local.contributor.affiliationDaghfal Nader, Joanne, Hamad Medical Corporation
local.contributor.affiliationThalib, Lukman, Qatar University
local.bibliographicCitation.issue1
local.identifier.doi10.1186/s12890-020-1102-5
local.identifier.absseo920501 - Child Health
dc.date.updated2020-07-19T08:26:51Z
dcterms.accessRightsOpen Access
dc.provenanceThis 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.
dc.rights.licenseCreative Commons License (Attribution 4.0 International)
CollectionsANU Research Publications

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