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      <P align="center"><B><font color="#0c2d83" size="+2">Article Reviews &amp; 
        Commentary</font></B> 

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      <P><font size="2"><b>Article Reviews by Thomas J. Mancuso, MD, FAAP </b></font>
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      <P><font size="2"><font color="#0c2d83" size="+1">Asthma Morbidity After 
        Short-Term use of Ibuprofen in Children.</font><font color="#0c2d83" size="+1"></font><FONT 
COLOR="#0c2d83"> <br>
        </FONT></font><font size="2"> Lesko SM, Louik C, Venzia RM et al. <I>Pediatrics 
        2002:109;e20</I> </font>
      <P> 
      <P><font size="2">This paper reports the results of a randomized, double-blind, 
        acetaminophen-controlled trial. The authors assigned children with asthma 
        who also had febrile illnesses to receive either ibuprofen at either 5 
        or 10 mg/kg/dose or acetaminophen 12 mg/kg/dose for fever control. The 
        groups were compared for rates of hospitalization and outpatient visits 
        for asthma exacerbations. A total of 1879 children were studied over a 
        28 month period with slightly over 600 children in each group. Children 
        were 6 months to 12 years of age and were followed for 4 weeks. Children 
        who received ibuprofen fared better with their asthma than those who received 
        acetaminophen. Compared to the acetaminophen group the relative risk for 
        hospitalization (0.63) or outpatient visit (0.56) was lower in the ibuprofen 
        group. Although the hospitalization rates for children in the two groups 
        did not differ statistically, the rate for an outpatient visit for asthma 
        was significantly lower in the ibuprofen group compared to the acetaminophen 
        group. </font>
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      <P><font color="#0c2d83" size="2"><b>Commentary</b></font> 
      <P><font size="2">Instead of confirming the safety of acetaminophen for 
        use in children with asthma, the results of this paper suggest that ibuprofen 
        may indeed reduce the risk of asthma exacerbation compared to acetaminophen. 
        At the very least, ibuprofen appears to be at least as safe in these children. 
        Asthma is an inflammatory illness, so it does not take a huge leap to 
        expect that an anti-inflammatory medication will have a beneficial effect 
        on the course of the disease. As is mentioned by the authors, patients 
        with cystic fibrosis have had benefit from ibuprofen treatment. The study 
        was not designed to evaluate the possibility that acetaminophen might 
        worsen asthma and I agree with the authors comments that it cannot be 
        concluded that this is the case based on the results of this investigation. 
        </font>



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