Journal article icon

Journal article

The association between ibuprofen administration in children and the risk of developing or exacerbating asthma: a systematic review and meta-analysis

Abstract:

Background: Ibuprofen is one of the most commonly used analgesic and antipyretic drugs in children. However, its potential causal role in childhood asthma pathogenesis remains uncertain. In this systematic review, we assessed the association between ibuprofen administration in children and the risk of developing or exacerbating asthma.


Methods: We searched MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus from inception to May 2022, with no language limits; searched relevant reviews; and performed citation searching. We included studies of any design that were primary empirical peer-reviewed publications, where ibuprofen use in children 0–18 years was reported. Screening was performed in duplicate by blinded review. In total, 24 studies met our criteria. Data were extracted according to PRISMA guidelines, and the risk of bias was assessed using RoB2 and NOS tools. Quantitative data were pooled using fixed effect models, and qualitative data were pooled using narrative synthesis. Primary outcomes were asthma or asthma-like symptoms. The results were grouped according to population (general, asthmatic, and ibuprofen-hypersensitive), comparator type (active and non-active) and follow-up duration (short- and long-term).


Results: Comparing ibuprofen with active comparators, there was no evidence of a higher risk associated with ibuprofen over both the short and long term in either the general or asthmatic population. Comparing ibuprofen use with no active alternative over a short-term follow-up, ibuprofen may provide protection against asthma-like symptoms in the general population when used to ease symptoms of fever or bronchiolitis. In contrast, it may cause asthma exacerbation for those with pre-existing asthma. However, in both populations, there were no clear long-term follow-up effects.


Conclusions: Ibuprofen use in children had no elevated risk relative to active comparators. However, use in children with asthma may lead to asthma exacerbation. The results are driven by a very small number of influential studies, and research in several key clinical contexts is limited to single studies. Both clinical trials and observational studies are needed to understand the potential role of ibuprofen in childhood asthma pathogenesis.

Publication status:
Published
Peer review status:
Peer reviewed

Actions

Access Document

Files:
Publisher copy:
10.1186/s12890-024-03179-3

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Oxford college:
St Cross College
Role:
Author
ORCID:
0000-0001-9548-7162
More by this author
Institution:
University of Oxford
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author
ORCID:
0000-0001-6206-0576
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Oxford college:
Green Templeton College
Role:
Author
ORCID:
0000-0003-1595-4846


Publisher:
BioMed Central
Journal:
BMC Pulmonary Medicine More from this journal
Volume:
24
Issue:
1
Article number:
412
Place of publication:
England
Publication date:
2024-08-26
Acceptance date:
2024-07-22
DOI:
EISSN:
1471-2466
Pmid:
39187775


Language:
English
Keywords:
Pubs id:
2023744
Local pid:
pubs:2023744
Deposit date:
2024-10-23
ARK identifier:

Terms of use


Views and Downloads






If you are the owner of this record, you can report an update to it here: Report update to this record

TO TOP