Ibuprofen efficacy, tolerability and safety in obese children: a systematic review



Shamsaee, Eman, Huws, Alaw, Gill, Andrea, McWilliam, Stephen J and Hawcutt, Daniel B ORCID: 0000-0002-8120-6507
(2023) Ibuprofen efficacy, tolerability and safety in obese children: a systematic review. Archives of Disease in Childhood, 108 (1). pp. 67-71.

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Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p>Childhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Any clinical setting.</jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p>Patients under 18 years who were overweight/obese.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Patients taking ibuprofen for any indication, dose or regimen.</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>The efficacy and tolerability of ibuprofen treatment in obese children and presence of any adverse drug reactions.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p><jats:p>One study described adverse effects. An increased risk of bleeding with ibuprofen was noted but did not differentiate between obese and non-obese children.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>There are little published data to guide clinicians prescribing ibuprofen in obese children.</jats:p></jats:sec><jats:sec><jats:title>PROSPERO registration number</jats:title><jats:p>CRD42021213500.</jats:p></jats:sec>

Item Type: Article
Uncontrolled Keywords: obesity, analgesia, child health, paediatrics, pain
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 18 Nov 2022 10:45
Last Modified: 07 Feb 2023 12:32
DOI: 10.1136/archdischild-2022-324652
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3166272