Prescription-acquired Acetaminophen Use and the Risk of Asthma in Adults: a Case-control Study

Overview

Journal Ann Pharmacother

Specialty Pharmacology

Date 2012 Nov 22

PMID 23170033

Citations 7

Authors

Mugdha Kelkar

Mario A Cleves

Howell R Foster

William R Hogan

Laura P James

Bradley C Martin

Affiliations

Soon will be listed here.

Abstract

Background: Studies have examined the association between acetaminophen use and asthma; however, their interpretation is limited by several methodologic issues.

Objective: To investigate the association between recent and chronic prescription-acquired acetaminophen use and asthma.

Methods: This retrospective case-control study used a 10% random sample of the IMS LifeLink commercial claims data from 1997 to 2009. Cases had to have at least 1 incident claim of asthma; 3:1 controls matched on age, sex, and region were randomly chosen. Acetaminophen exposure, dose, and duration were measured in the 7- and 30-day (recent) and the 1-year (chronic) look-back periods. Multivariable conditional logistic regression was used to estimate the risk of asthma associated with acetaminophen use adjusted for comorbidities, other drugs increasing asthma risk, and health system factors.

Results: There were 28,892 cases and 86,676 controls, with mean age of 42.8 years; 37.7% were males, and 22.6% of cases and 18.2% of controls had acetaminophen exposure in the pre-index year, with mean cumulative doses of 78.7 g and 59.8 g, respectively. There was no significant association between recent prescription acetaminophen exposure and asthma (7 days: OR 1.02, p = 0.74; 30 days: OR 0.97, p = 0.38). Cumulative prescription acetaminophen dose in the year prior increased asthma risk compared to acetaminophen nonusers (≤1 kg: OR 1.09, p < 0.001 and >1 kg: OR = 1.60, p = 0.02). Duration of prescription acetaminophen use greater than 30 days was associated with elevated asthma risk (OR 1.39, p < 0.001).

Conclusions: Chronic prescription-acquired acetaminophen use was associated with an increased risk of asthma, while recent use was not. However, over-the-counter acetaminophen use was not captured in this study and further epidemiologic research with complete acetaminophen exposure ascertainment and research on pathophysiologic mechanisms is needed to confirm these relationships.

Citing Articles

Racing against time: leveraging preclinical models to understand pulmonary susceptibility to perinatal acetaminophen exposures.

McCulley D, Jensen E, Sucre J, McKenna S, Sherlock L, Dobrinskikh E Am J Physiol Lung Cell Mol Physiol. 2022; 323(1):L1-L13.

PMID: 35503238 PMC: 9208439. DOI: 10.1152/ajplung.00080.2022.

The association between exacerbation of chronic obstructive pulmonary disease and timing of paracetamol use: a cohort study in elderly Australians.

Kelly T, Ward M, Pratt N, Ramsay E, Gillam M, Roughead E Respir Res. 2022; 23(1):80.

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Pulmonary implications of acetaminophen exposures independent of hepatic toxicity.

Dobrinskikh E, Al-Juboori S, Zarate M, Zheng L, De Dios R, Balasubramaniyan D Am J Physiol Lung Cell Mol Physiol. 2021; 321(5):L941-L953.

PMID: 34585971 PMC: 8616618. DOI: 10.1152/ajplung.00234.2021.

Extrahepatic toxicity of acetaminophen: critical evaluation of the evidence and proposed mechanisms.

Kennon-McGill S, McGill M J Clin Transl Res. 2019; 3(3):297-310.

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