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Ibuprofen efficacy, tolerability and safety in obese children: a systematic review
Eman Shamsaee1, Alaw Huws2, Andrea Gill3
1Hull University Teaching Hospitals NHS Trust, Hull, UK.
Insights
Limited data exists on ibuprofen efficacy in obese children. One study showed adequate pain control with a 5 mg/kg dose, but more research is needed for dosing and adverse effects in this population.
Area of Science:
- Pharmacology
- Pediatrics
- Drug Efficacy
Background:
- Childhood obesity can alter drug disposition, potentially affecting the efficacy of common medications like ibuprofen.
- There is a need to understand how ibuprofen works in obese children to ensure effective treatment.
Approach:
- A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searches across 12 databases identified 1305 studies; four met inclusion criteria.
- Two reviewers assessed study eligibility and quality.
Key Points:
- Four studies (three retrospective cohort, one case study) involving overweight/obese children under 18 were included.
- Dosing regimens varied, including weight-based (5 mg/kg), age-based, and adjusted body weight.
- One study indicated adequate pain control with 5 mg/kg ibuprofen in obese children, while others did not compare efficacy between obese and non-obese groups.
- An increased risk of bleeding was noted, but not specifically linked to obesity.
Conclusions:
- Published data guiding ibuprofen prescribing in obese children is scarce.
- Further research is required to establish optimal dosing and safety profiles for ibuprofen in pediatric obesity.
Objective:
Childhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.
Design:
A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Studies were identified from 12 databases. Two independent reviewers evaluated studies against the inclusion criteria and assessed for methodological quality.
Setting:
Any clinical setting.
Patients:
Patients under 18 years who were overweight/obese.
Interventions:
Patients taking ibuprofen for any indication, dose or regimen.
Main Outcome Measures:
The efficacy and tolerability of ibuprofen treatment in obese children and presence of any adverse drug reactions.
Results:
Searches identified 1305 studies. Four studies met inclusion criteria: three retrospective cohort studies (n=583, median age: 6 years, range: 1-18 years; n=200, median age: 11 years, range: 3-18 years; n=358 median age: 3.1 years, range: 1.2-8.5 years, respectively) and one case study. Each study differed in their method of dosing ibuprofen (weight-based, age-based and adjusted body weight dosing). Various doses were used: 5 mg/kg every 6 hours, 400 mg three times a day, 120 mg/dose and a dose calculated using adjusted body weight. One study reported efficacy (obese n=189, non-obese, n=394), where adequate pain control was achieved using 5 mg/kg. The other three studies did not determine if efficacy differed between obese and non-obese children.One study described adverse effects. An increased risk of bleeding with ibuprofen was noted but did not differentiate between obese and non-obese children.
Conclusion:
There are little published data to guide clinicians prescribing ibuprofen in obese children.
Prospero Registration Number:
CRD42021213500.
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