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The prevalence of ibuprofen-sensitive asthma in children: a randomized controlled bronchoprovocation challenge study
Jason S Debley1, Edward R Carter, Ronald L Gibson
1Department of Pediatrics, Division of Pulmonary Medicine, University of Washington, Seattle, Washington 98105, USA. jason.debley@seattlechildrens.org
Insights
The prevalence of ibuprofen-sensitive asthma in school-aged children with mild or moderate persistent asthma is low, affecting 2% of participants. Healthcare providers should consider ibuprofen-induced bronchospasm in pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Allergy and Immunology
Background:
- Asthma is a common chronic respiratory disease in children.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can trigger asthma exacerbations in sensitive individuals.
- Identifying ibuprofen sensitivity is crucial for managing pediatric asthma effectively.
Purpose of the Study:
- To determine the prevalence of ibuprofen-sensitive asthma in school-aged children with mild or moderate persistent asthma.
- To assess the risk of ibuprofen-induced bronchospasm in this pediatric population.
Main Methods:
- A randomized, double-blind, placebo-controlled, crossover bronchoprovocation challenge study was conducted.
- 100 children aged 6-18 years with mild or moderate persistent asthma participated.
- Spirometry was used to measure lung function changes after ibuprofen or placebo administration.
Main Results:
- The prevalence of ibuprofen-sensitive asthma was found to be 2% (95% CI: 0.2%-7%) among the 100 participants.
- Two patients met the criteria for ibuprofen sensitivity, with no prior known ibuprofen exposure.
- No bronchospasm occurred after placebo administration in these patients.
Conclusions:
- Ibuprofen-sensitive asthma is uncommon but present in children with mild to moderate persistent asthma.
- Clinicians should consider the potential for ibuprofen-induced bronchospasm before prescribing ibuprofen to children with asthma.
- Further investigation may be warranted to understand the mechanisms and long-term implications of NSAID sensitivity in pediatric asthma.
Objective:
To determine the prevalence of ibuprofen-sensitive asthma in school-aged children with mild or moderate persistent asthma.
Study Design:
A randomized, double-blind, placebo-controlled, crossover bronchoprovocation challenge study in children 6 to 18 years of age with mild or moderate persistent asthma. Patients received a single dose of ibuprofen or placebo, per randomization, and then returned 2 to 7 days later to repeat the procedures after taking that study drug not received at the first visit. At each visit, patients performed spirometry before and (1/2), 1, 2, and 4 hours after administration of study drug. We defined bronchospasm as a > or =20% decrease from baseline in the forced expired volume in the first second (FEV1) and ibuprofen sensitivity as bronchospasm following administration of ibuprofen but not placebo.
Results:
Of the 127 patients screened, 100 (mean age, 11 years) completed the study. Two patients met criteria for ibuprofen-sensitive asthma, resulting in a prevalence of 2% (95% CI: 0.2%-7%). Neither patient was known to have had any exposure to ibuprofen before the study.
Conclusion:
The prevalence of ibuprofen-sensitive asthma was low but non-zero in this group of children with mild or moderate asthma. The possibility of ibuprofen-induced bronchospasm should be considered before administering ibuprofen to children with asthma.
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