K Wickens1, R Beasley, I Town, M Epton, P Pattemore, T Ingham, J Crane. 1. Wellington Asthma Research Group, Department of Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. kristin.wickens@otago.ac.nz
Abstract
BACKGROUND: Despite reports of positive associations between paracetamol and asthma, the nature of these associations is unclear. OBJECTIVE: We aimed to investigate the associations between infant and childhood paracetamol use and atopy and allergic disease at 5-6 years. METHODS: In a birth cohort study, we collected reported paracetamol exposure between birth and 15 months in Christchurch (n=505) and between 5 and 6 years for all participants (Christchurch and Wellington) (n=914). Outcome data for reported current asthma, reported wheeze and atopy (measured using skin prick tests) were collected at 6 years for all participants. Logistic regression models were adjusted for potential confounders, including the number of chest infections and antibiotic use. RESULTS: Paracetamol exposure before the age of 15 months was associated with atopy at 6 years [adjusted odds ratio (OR)=3.61, 95% confidence interval (CI) 1.33-9.77]. Paracetamol exposure between 5 and 6 years showed dose-dependent associations with reported wheeze and current asthma but there was no association with atopy. Compared with use 0-2 times, the adjusted OR (95% CI) were wheeze 1.83 (1.04-3.23) for use 3-10 times, and 2.30 (1.28-4.16) for use >10 times: current asthma 1.63 (0.92-2.89) for use 3-10 times and 2.16 (1.19-3.92) for use >10 times: atopy 0.96 (0.59-1.56) for use 3-10 times, and 1.05 (0.62-1.77) for use >10 times. CONCLUSION AND CLINICAL RELEVANCE: Our findings suggest that paracetamol has a role in the development of atopy, and the maintenance of asthma symptoms. Before recommendations for clinical practice can be made, randomized-controlled trials are needed to determine whether these associations are causal.
BACKGROUND: Despite reports of positive associations between paracetamol and asthma, the nature of these associations is unclear. OBJECTIVE: We aimed to investigate the associations between infant and childhood paracetamol use and atopy and allergic disease at 5-6 years. METHODS: In a birth cohort study, we collected reported paracetamol exposure between birth and 15 months in Christchurch (n=505) and between 5 and 6 years for all participants (Christchurch and Wellington) (n=914). Outcome data for reported current asthma, reported wheeze and atopy (measured using skin prick tests) were collected at 6 years for all participants. Logistic regression models were adjusted for potential confounders, including the number of chest infections and antibiotic use. RESULTS:Paracetamol exposure before the age of 15 months was associated with atopy at 6 years [adjusted odds ratio (OR)=3.61, 95% confidence interval (CI) 1.33-9.77]. Paracetamol exposure between 5 and 6 years showed dose-dependent associations with reported wheeze and current asthma but there was no association with atopy. Compared with use 0-2 times, the adjusted OR (95% CI) were wheeze 1.83 (1.04-3.23) for use 3-10 times, and 2.30 (1.28-4.16) for use >10 times: current asthma 1.63 (0.92-2.89) for use 3-10 times and 2.16 (1.19-3.92) for use >10 times: atopy 0.96 (0.59-1.56) for use 3-10 times, and 1.05 (0.62-1.77) for use >10 times. CONCLUSION AND CLINICAL RELEVANCE: Our findings suggest that paracetamol has a role in the development of atopy, and the maintenance of asthma symptoms. Before recommendations for clinical practice can be made, randomized-controlled trials are needed to determine whether these associations are causal.
Authors: William J Sheehan; David T Mauger; Ian M Paul; James N Moy; Susan J Boehmer; Stanley J Szefler; Anne M Fitzpatrick; Daniel J Jackson; Leonard B Bacharier; Michael D Cabana; Ronina Covar; Fernando Holguin; Robert F Lemanske; Fernando D Martinez; Jacqueline A Pongracic; Avraham Beigelman; Sachin N Baxi; Mindy Benson; Kathryn Blake; James F Chmiel; Cori L Daines; Michael O Daines; Jonathan M Gaffin; Deborah A Gentile; W Adam Gower; Elliot Israel; Harsha V Kumar; Jason E Lang; Stephen C Lazarus; John J Lima; Ngoc Ly; Jyothi Marbin; Wayne J Morgan; Ross E Myers; J Tod Olin; Stephen P Peters; Hengameh H Raissy; Rachel G Robison; Kristie Ross; Christine A Sorkness; Shannon M Thyne; Michael E Wechsler; Wanda Phipatanakul Journal: N Engl J Med Date: 2016-08-18 Impact factor: 91.245
Authors: Maria C Magnus; Øystein Karlstad; Siri E Håberg; Per Nafstad; George Davey Smith; Wenche Nystad Journal: Int J Epidemiol Date: 2016-02-09 Impact factor: 7.196