Prescription-acquired acetaminophen use and the risk of asthma in adults: a case-control study. Ann Pharmacother 2012 Dec;46(12):1598-608
Date
11/22/2012Pubmed ID
23170033Pubmed Central ID
PMC3793244DOI
10.1345/aph.1R430Scopus ID
2-s2.0-84872255923 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
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.
Author List
Kelkar M, Cleves MA, Foster HR, Hogan WR, James LP, Martin BCAuthor
William R. Hogan MD Director, Professor in the Data Science Institute department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AcetaminophenAdult
Analgesics, Non-Narcotic
Asthma
Case-Control Studies
Dose-Response Relationship, Drug
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prescription Drugs
Retrospective Studies
Risk
Time Factors
