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

Autor:	Shamsaee E; Hull University Teaching Hospitals NHS Trust, Hull, UK., Huws A; School of Medicine, University of Liverpool, Liverpool, UK., Gill A; Paediatric Medicines Research Unit and Pharmacy Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK., McWilliam SJ; Department of Women's and Children's Health, University of Liverpool, Liverpool, UK., Hawcutt DB; Paediatric Medicines Research Unit and Pharmacy Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK dhawcutt@liverpool.ac.uk.; Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.; NIHR Alder Hey Clinical Research Facility, Aldey Hey Children's Hospital, Liverpool, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2023 Jan; Vol. 108 (1), pp. 67-71. Date of Electronic Publication: 2022 Nov 16.
DOI:	10.1136/archdischild-2022-324652
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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