Popular pain and fever reliever does not worsen asthma in children, study shows

WIn a study of children with mild, persistent asthma, scientists found that acetaminophen was tolerated without the worsening of asthma, when compared with ibuprofen use. The study, funded by the National Heart, Lung, and Blood Institute's asthma network (AsthmaNet), appears in the August 18, 2016, issue of the New England Journal of Medicine.

While acetaminophen (e.g., Tylenol, Panadol) and ibuprofen (e.g., Advil, Motrin) are often used to treat pain or fevers in children, some prior reports suggested that use of acetaminophen in children with asthma was associated with the worsening of asthma. Consequently, some health care providers avoided the use of acetaminophen in children with the disease.

To assess the impact of acetaminophen use on children's asthma, AsthmaNet investigators studied 300 children, aged 1 to 5 years old, who had mild, persistent asthma, defined as symptoms on more than 2 days out of a week but not daily. All children required daily inhaled treatments to manage their asthma. During the study, caregivers used either acetaminophen or ibuprofen whenever a child needed pain relief or had a fever. None of the study investigators, children, or caregivers knew which study drug each child was receiving.

The scientists did not detect any worsening of asthma in the children treated with acetaminophen compared with those receiving ibuprofen. This was measured by asthma exacerbation rate, the number of days of asthma control, the need for rescue medications, and unscheduled medical visits for asthma. They also did not find any significant differences in safety between the two drugs.

While the authors noted that these results should be used to treat pain or fevers in children with characteristics similar to those studied, the results could impact the care of many children with asthma.