MedWire News: Results from a US study support an association between acetaminophen (paracetamol) use and an increased risk for asthma symptoms.
Richard Beasley, from the Medical Research Institute of New Zealand in Wellington, and colleagues observe: "Evidence is accumulating that the use of acetaminophen may increase the risk of developing asthma and that its widespread increasing use over the last 30 years may have contributed to the increasing prevalence of asthma in different countries worldwide."
To investigate further, the researchers studied data on 322,959 adolescents, aged 13-14 years, from 113 centers in 50 countries who participated in the International Study of Asthma and Allergies in Childhood (ISAAC).
All of the children completed written and video questionnaires in which they provided information on their use of acetaminophen in the previous 12 months. They also provided information on whether they had recently experienced symptoms of asthma (wheezing or whistling in the chest), rhinoconjunctivitis (sneezing or a runny or blocked nose in the absence of a cold of influenza), and eczema (recurrent itchy rash).
Overall, 73% of adolescents had used acetaminophen at least once in the previous 12-month period (medium use), ranging from 41% in China to 92% in Panama, and 30% had used the drug at least once a month (high use).
The researchers found that acetaminophen use in the past 12 months was associated with a significant exposure-dependent increased risk for current asthma symptoms. Indeed, after accounting for factors such as gender, maternal smoking, and diet, medium and high use of acetaminophen in the previous 12 months was associated with a respective 1.38- and 2.36-fold increased risk for current asthma symptoms versus no use.
They also found that, compared with no use, medium and high use of acetaminophen in the past 12 months was associated with a respective 1.33- and 2.18-fold increased risk for current rhinoconjunctivitis symptoms and a 1.32- and 1.87-fold increased risk for current symptoms of eczema, after adjustment for confounding factors.
Beasley and team conclude in the American Journal of Respiratory and Critical Care Medicine: "The study findings add to the evidence that acetaminophen use in childhood may be an important risk factor for the development and/or maintenance of asthma.
"However, it is not possible in a study of this design to determine whether the positive association observed was causal. As a result, randomized controlled trials are now urgently required to investigate this relationship further and to guide the use of antipyretics not only in children but also in pregnancy and adult life."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
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