Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma
Background Antipyretics are widely prescribed in pediatric practice. Some reports have mentioned that acetaminophen and non-steroid anti-inflammatory drugs may negatively affect asthma control by causing asthma exacerbation (AE). However, many confounding factors can also influence the risks. We ass...
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PeerJ Inc.
2019-04-01
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| Online Access: | https://peerj.com/articles/6760.pdf |
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| author | Lin-Shien Fu Che-Chen Lin Chia-Yi Wei Ching-Heng Lin Yung-Chieh Huang |
| author_facet | Lin-Shien Fu Che-Chen Lin Chia-Yi Wei Ching-Heng Lin Yung-Chieh Huang |
| author_sort | Lin-Shien Fu |
| collection | DOAJ |
| description | Background Antipyretics are widely prescribed in pediatric practice. Some reports have mentioned that acetaminophen and non-steroid anti-inflammatory drugs may negatively affect asthma control by causing asthma exacerbation (AE). However, many confounding factors can also influence the risks. We assessed the impact of using acetaminophen or ibuprofen on AE in asthmatic children, especially those with strong risk factors. Methods We used the 2010 Taiwan National Health Insurance Research Database and identified 983 children with persistent asthma aged 1–5 years old; among them, 591 used acetaminophen alone and 392 used ibuprofen alone in 2010. Then, we analyzed the risk of AE over 52 weeks in the patients with and without severe AE in the previous year. Results The ibuprofen group had a higher risk of an emergency room (ER) visit or hospitalization for AE (odds ratio (OR) = 2.10, 95% confidence interval (CI) [1.17–3.76], P = 0.01). Among asthmatic children who had severe AE in the previous year, the risk of AE was higher in the ibuprofen group than in the acetaminophen group (OR = 3.28, 95% CI [1.30–8.29], P = 0.01), where as among those who did not, the risks of AE were similar between the acetaminophen and ibuprofen groups (OR = 1.52, 95% CI [0.71–3.25], P = 0.28). Conclusions Among young asthmatic children, use of ibuprofen was associated with a higher risk of AE than acetaminophen, if they had severe AE with ER visit or hospitalization in the previous year. Pediatricians should use antipyretics among children with asthma after a full evaluation of the risk. |
| first_indexed | 2024-03-09T08:19:27Z |
| format | Article |
| id | doaj.art-4f9d73c3a6cc43c39dfe3211b9df9313 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T08:19:27Z |
| publishDate | 2019-04-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-4f9d73c3a6cc43c39dfe3211b9df93132023-12-02T21:53:40ZengPeerJ Inc.PeerJ2167-83592019-04-017e676010.7717/peerj.6760Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthmaLin-Shien Fu0Che-Chen Lin1Chia-Yi Wei2Ching-Heng Lin3Yung-Chieh Huang4Department of Pediatrics, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Pediatrics, Taichung Veterans General Hospital, Taichung, TaiwanBackground Antipyretics are widely prescribed in pediatric practice. Some reports have mentioned that acetaminophen and non-steroid anti-inflammatory drugs may negatively affect asthma control by causing asthma exacerbation (AE). However, many confounding factors can also influence the risks. We assessed the impact of using acetaminophen or ibuprofen on AE in asthmatic children, especially those with strong risk factors. Methods We used the 2010 Taiwan National Health Insurance Research Database and identified 983 children with persistent asthma aged 1–5 years old; among them, 591 used acetaminophen alone and 392 used ibuprofen alone in 2010. Then, we analyzed the risk of AE over 52 weeks in the patients with and without severe AE in the previous year. Results The ibuprofen group had a higher risk of an emergency room (ER) visit or hospitalization for AE (odds ratio (OR) = 2.10, 95% confidence interval (CI) [1.17–3.76], P = 0.01). Among asthmatic children who had severe AE in the previous year, the risk of AE was higher in the ibuprofen group than in the acetaminophen group (OR = 3.28, 95% CI [1.30–8.29], P = 0.01), where as among those who did not, the risks of AE were similar between the acetaminophen and ibuprofen groups (OR = 1.52, 95% CI [0.71–3.25], P = 0.28). Conclusions Among young asthmatic children, use of ibuprofen was associated with a higher risk of AE than acetaminophen, if they had severe AE with ER visit or hospitalization in the previous year. Pediatricians should use antipyretics among children with asthma after a full evaluation of the risk.https://peerj.com/articles/6760.pdfNHIRDAsthmaAcute exacerbationIbuprofenAcetaminophenTaiwan |
| spellingShingle | Lin-Shien Fu Che-Chen Lin Chia-Yi Wei Ching-Heng Lin Yung-Chieh Huang Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma PeerJ NHIRD Asthma Acute exacerbation Ibuprofen Acetaminophen Taiwan |
| title | Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| title_full | Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| title_fullStr | Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| title_full_unstemmed | Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| title_short | Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| title_sort | risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma |
| topic | NHIRD Asthma Acute exacerbation Ibuprofen Acetaminophen Taiwan |
| url | https://peerj.com/articles/6760.pdf |
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