No Difference In Asthma Exacerbations Between Acetaminophen and Ibuprofen in Young Children Interview with:

Wanda Phipatanakul, MD, MS Associate Professor of Pediatrics Harvard Medical School Director, Asthma Clinical Research Center Boston Children's Hospital Asthma, Allergy and Immunology Boston, MA 02115

Dr. Wanda Phipatanakul

Wanda Phipatanakul, MD, MS
Associate Professor of Pediatrics
Harvard Medical School
Director, Asthma Clinical Research Center
Boston Children’s Hospital
Asthma, Allergy and Immunology
Boston, MA 02115 What is the background for this study? What are the main findings?

Response:  Acetaminophen (e.g., Tylenol, Panadol) and ibuprofen (e.g., Advil, Motrin) are the only available treatments for pain and fever in toddlers and the most commonly utilized medications worldwide. Recently there has been controversy and even alarm with suggestive observational data that acetaminophen makes asthma worse. This has led some experts to recommend the avoidance of acetaminophen in children with asthma. We sought to find the answer to this burning question through the first prospective, double-blind, randomized clinical trial comparing acetaminophen versus ibuprofen head to head for use when clinically indicated for fever or pain. Is there a difference in asthma morbidity (exacerbations) in young children between the age of 12-59 months, who have asthma?  What are the main findings?

Response: We found that there was NO difference between the two medications and asthma exacerbations, when used as typically indicated in preschool children. What should readers take away from your report?

Response: The readers should be assured that in young children with asthma, there is no difference in asthma exacerbations between acetaminophen versus ibuprofen for fever or pain.

Our findings should alleviate the concerns for safety that were based on observational data. What recommendations do you have for future research as a result of this study?

Response: Studies in older children with more severe asthma may be important. Is there anything else you would like to add?

Response: Given that acetaminophen and ibuprofen are the only therapies available in this age group for pain and fever, and asthma is so common, our findings are very important and will be of interest to all clinicians and families worldwide.

Before one jumps to conclusions on retrospective, observational findings– blinded, randomized, prospective clinical trials are needed to answer important clinical questions Thank you for your contribution to the community.


Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma

William J. Sheehan, M.D., David T. Mauger, Ph.D., Ian M. Paul, M.D., James N. Moy, M.D., Susan J. Boehmer, M.A., Stanley J. Szefler, M.D., Anne M. Fitzpatrick, Ph.D., Daniel J. Jackson, M.D., Leonard B. Bacharier, M.D., Michael D. Cabana, M.D., Ronina Covar, M.D., Fernando Holguin, M.D., Robert F. Lemanske, Jr., M.D., Fernando D. Martinez, M.D., Jacqueline A. Pongracic, M.D., Avraham Beigelman, M.D., Sachin N. Baxi, M.D., Mindy Benson, M.S.N., P.N.P., Kathryn Blake, Pharm.D., James F. Chmiel, M.D., Cori L. Daines, M.D., Michael O. Daines, M.D., Jonathan M. Gaffin, M.D., Deborah A. Gentile, M.D., W. Adam Gower, M.D., Elliot Israel, M.D., Harsha V. Kumar, M.D., Jason E. Lang, M.D., M.P.H., Stephen C. Lazarus, M.D., John J. Lima, Pharm.D., Ngoc Ly, M.D., Jyothi Marbin, M.D., Wayne J. Morgan, M.D., Ross E. Myers, M.D., J. Tod Olin, M.D., Stephen P. Peters, M.D., Ph.D., Hengameh H. Raissy, Pharm.D., Rachel G. Robison, M.D., Kristie Ross, M.D., Christine A. Sorkness, Pharm.D., Shannon M. Thyne, M.D., Michael E. Wechsler, M.D., and Wanda Phipatanakul, M.D., for the NIH/NHLBI AsthmaNet*

N Engl J Med 2016; 375:619-630 August 18, 2016
DOI: 10.1056/NEJMoa1515990

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on August 18, 2016 by Marie Benz MD FAAD