paracetamol

Failure of ductal closure of a patent ductus arteriosus after paracetamol treatment versus ibuprofen, indomethacin, or placebo/no intervention, in preterm/low-birth-weight infants

increases

Not recorded as a finding: this platform holds no node for the endpoint

Moderate-quality evidence according to GRADE suggests that paracetamol is as effective as ibuprofen; low-quality evidence suggests paracetamol to be more effective than placebo or no intervention; and low-quality evidence suggests paracetamol as effective as indomethacin in closing a PDA.

PMID:31985831 · one of two readings recorded this

failure to close PDA, paracetamol vs indomethacin

no effect

There was no significant difference in the failure to close a PDA (typical RR 0.96, 95% CI 0.55 to 1.65; I² = 11%; typical RD -0.01, 95% CI -0.09 to 0.08; I² = 17%) (low quality of evidence).

PMID:31985831 · one of two readings recorded this

Neurodevelopmental outcome at 18-24 months, vs ibuprofen

no effect, n = 61

There were no significant differences in the neurological outcomes at 18 to 24 months (n = 61); (low quality of evidence).

PMID:31985831 · one of two readings recorded this

serum creatinine, paracetamol vs ibuprofen

decreases

The serum levels of creatinine were lower in the paracetamol group compared with the ibuprofen group in four studies (moderate quality of evidence), as were serum bilirubin levels following treatment in two studies (n = 290).

PMID:31985831 · one of two readings recorded this

all-cause mortality and liver transplantation, N-acetylcysteine vs placebo, in non-paracetamol-induced acute liver failure

no effect, RR 0.88, 95% CI 0.57 to 1.37 (adults, 21-day mortality)

Not recorded as a finding: subject_absent

For all-cause mortality at 21 days between adults receiving N-acetylcysteine versus placebo, there was inconclusive evidence of effect (N-acetylcysteine 24/81 (29.6%) versus placebo 31/92 (33.7%); RR 0.88, 95% CI 0.57 to 1.37; low certainty evidence).

PMID:33294991 · one of two readings recorded this

all-cause mortality at 21 days, adults

no effect, RR 0.88, 95% CI 0.57 to 1.37

For all-cause mortality at 21 days between adults receiving N-acetylcysteine versus placebo, there was inconclusive evidence of effect (N-acetylcysteine 24/81 (29.6%) versus placebo 31/92 (33.7%); RR 0.88, 95% CI 0.57 to 1.37; low certainty evidence).

PMID:33294991 · one of two readings recorded this

All-cause mortality at 21 days (adults) / one year (children)

no effect

For all-cause mortality at 21 days between adults receiving N-acetylcysteine versus placebo, there was inconclusive evidence of effect (N-acetylcysteine 24/81 (29.6%) versus placebo 31/92 (33.7%); RR 0.88, 95% CI 0.57 to 1.37; low certainty evidence).

PMID:33294991 · one of two readings recorded this

all-cause mortality at one year, children

no effect, RR 1.47, 95% CI 0.85 to 2.53

Similarly, for all-cause mortality at one year between children receiving N-acetylcysteine versus placebo, there was inconclusive evidence of effect (25/92 (27.2%) versus 17/92 (18.5%); RR 1.47, 95% CI 0.85 to 2.53; low certainty evidence).

PMID:33294991 · one of two readings recorded this

Liver transplantation

no effect

For liver transplantation at 21 days in the trial with adults, there was inconclusive evidence of effect (RR 0.72, 95% CI 0.49 to 1.06; low certainty evidence).

PMID:33294991 · one of two readings recorded this

Serious adverse events (children)

no effect, RR 1.25, 95% CI 0.35 to 4.51

There was inconclusive evidence of effect on serious adverse events in the trial with children (RR 1.25, 95% CI 0.35 to 4.51; low certainty evidence).

PMID:33294991 · one of two readings recorded this

need for additional pain relief

decreases, RR 0.34, 95% CI 0.21 to 0.55, n = 1132

fewer women may need additional pain relief with paracetamol compared with placebo (average RR 0.34, 95% CI 0.21 to 0.55; 8 trials, 1132 women).

PMID:34559424 · one of two readings recorded this

pain relief (SMD), exercise vs usual care

increases

For pain relief, exercise was more effective than usual care at or nearest to four (SMD=1.31, 95% CrI 0.61 to 2.01), eight (SMD=0.78, 95% CrI 0.58 to 0.98) and 24 weeks (SMD=0.19, 95% CrI 0.00 to 0.38).

PMID:36593092 · one of two readings recorded this

Adverse events, paracetamol+NSAID combination

no effect

Paracetamol plus an NSAID did not increase the risk of AEs in low back pain or osteoarthritis compared to their NSAID monotherapy or placebo (comparison 1.6.1–1.6.5).

PMID:38937394 · one of two readings recorded this

Adverse events, paracetamol+opioid combination

increases

Five out of the nine comparisons of paracetamol plus an opioid analgesic (tramadol or oxycodone) compared with placebo increased the risk of adverse events in low back pain and osteoarthritis (comparison 1.6.7, 1.6.8, 1.6.10, 1.6.11, 1.6.14).

PMID:38937394 · one of two readings recorded this

adverse events, paracetamol plus opioid vs placebo

increases

Five out of the nine comparisons of paracetamol plus an opioid analgesic (tramadol or oxycodone) compared with placebo increased the risk of adverse events in low back pain and osteoarthritis (comparison 1.6.7, 1.6.8, 1.6.10, 1.6.11, 1.6.14).

PMID:38937394 · one of two readings recorded this

disability score, low back pain, paracetamol plus ibuprofen vs ibuprofen, immediate term

decreases, MD -9.2, 95% CI -16.8 to -1.6

Paracetamol plus NSAID combination therapy improved disability scores in low back pain in one combination, paracetamol plus ibuprofen versus ibuprofen, immediate term (MD −9.2, 95% CI −16.8 to −1.6; one study; moderate evidence).

PMID:38937394 · one of two readings recorded this

Disability scores

decreases, MD -9.2, 95% CI -16.8 to -1.6 (paracetamol+ibuprofen vs ibuprofen, LBP, immediate term)

Paracetamol plus NSAID combination therapy improved disability scores in low back pain in one combination, paracetamol plus ibuprofen versus ibuprofen, immediate term (MD −9.2, 95% CI −16.8 to −1.6; one study; moderate evidence).

PMID:38937394 · one of two readings recorded this

Low back pain and osteoarthritis pain intensity on VAS/NRS/categorical pain scales, mean difference, by specific paracetamol combination versus monotherapy or placebo and timepoint

decreases

Not recorded as a finding: this platform holds no node for the endpoint

Paracetamol plus tramadol reduced pain compared with placebo at intermediate term for low back pain (MD −11.7, 95% CI −19.2 to −4.3; two studies, very low evidence) and osteoarthritis (MD −6.8, 95% CI −12.7 to −0.9; one study, moderate evidence).

PMID:38937394 · one of two readings recorded this

Pain intensity, paracetamol+tramadol vs placebo

decreases, MD -11.7, 95% CI -19.2 to -4.3 (LBP, intermediate term); MD -6.8, 95% CI -12.7 to -0.9 (OA, intermediate term)

Paracetamol plus tramadol reduced pain compared with placebo at intermediate term for low back pain (MD −11.7, 95% CI −19.2 to −4.3; two studies, very low evidence) and osteoarthritis (MD −6.8, 95% CI −12.7 to −0.9; one study, moderate evidence).

PMID:38937394 · one of two readings recorded this

pain, low back pain and osteoarthritis, paracetamol plus tramadol vs placebo, intermediate term

decreases, LBP: MD -11.7, 95% CI -19.2 to -4.3; OA: MD -6.8, 95% CI -12.7 to -0.9

Paracetamol plus tramadol reduced pain compared with placebo at intermediate term for low back pain (MD −11.7, 95% CI −19.2 to −4.3; two studies, very low evidence) and osteoarthritis (MD −6.8, 95% CI −12.7 to −0.9; one study, moderate evidence).

PMID:38937394 · one of two readings recorded this

Quality of life (SF-36)

no effect

Paracetamol plus tramadol did not improve quality of life compared with placebo in low back pain or osteoarthritis populations (ESM).

PMID:38937394 · one of two readings recorded this

quality of life (SF-36), paracetamol plus tramadol vs placebo

no effect

Paracetamol plus tramadol did not improve quality of life compared with placebo in low back pain or osteoarthritis populations (ESM).

PMID:38937394 · one of two readings recorded this

serious adverse events, paracetamol combination therapies vs individual controls

no effect

No combination therapy increased the risk of SAEs compared to individual controls (ESM).

PMID:38937394 · one of two readings recorded this

ADHD diagnosis

increases, odds increased 2.25 to 2.86 times (cord plasma biomarker dose-response)

A strong dose-response relationship between fetal acetaminophen exposure, measured by cord plasma biomarkers, and ADHD diagnoses was observed, increasing the odds of an ADHD diagnosis in 2.25 to 2.86 times.

PMID:42500177 · one of two readings recorded this

ADHD diagnosis (cord plasma acetaminophen biomarker dose-response)

increases, odds of ADHD diagnosis increased 2.25 to 2.86 times

A strong dose-response relationship between fetal acetaminophen exposure, measured by cord plasma biomarkers, and ADHD diagnoses was observed, increasing the odds of an ADHD diagnosis in 2.25 to 2.86 times.

PMID:42500177 · one of two readings recorded this

ADHD symptoms

increases, RR 1.45, 95% CI 1.18 to 1.78

Self-reported maternal acetaminophen use and an increased risk of ADHD symptoms in children (RR 1.45, 95% CI 1.18 to 1.78) was also noted.

PMID:42500177 · one of two readings recorded this

ASD symptoms presence

no effect, OR 1.16, 95% CI 0.94 to 1.43, p= 0.1719, I2 = 0%

A higher risk of presenting ASD symptoms by 16% was observed, albeit not statistically significant (OR 1.16, 95% CI 0.94 to 1.43, p= 0.1719, I2 = 0%) and with no substantial heterogeneity in the sensitivity analysis (Supplemental material: Figure S2).

PMID:42500177 · one of two readings recorded this

Autism spectrum disorder (ASD) diagnosis

increases, OR 1.18, 95% CI 1.15 to 1.32, p <0.0001, I2 = 45.9%

The pooled results showed that acetaminophen use during pregnancy increased the risk of ASD diagnosis by 18% (OR 1.18, 95% CI 1.15 to 1.32, p <0.0001; I2 = 45.9%).

PMID:42500177 · both readings recorded this

Autism spectrum disorder (ASD) diagnosis and ASD symptoms in offspring, pooled odds ratio across observational cohort studies of prenatal acetaminophen exposure

increases, OR 1.18, 95% CI 1.15 to 1.32, p <0.0001, I2 = 45.9%

Not recorded as a finding: this platform holds no node for the endpoint

The pooled results showed that acetaminophen use during pregnancy increased the risk of ASD diagnosis by 18% (OR 1.18, 95% CI 1.15 to 1.32, p <0.0001; I2 = 45.9%).

PMID:42500177 · one of two readings recorded this

Autism Spectrum Disorder (ASD) diagnosis in offspring, pooled odds ratio across cohort studies

increases, OR 1.18, 95% CI 1.15 to 1.32, p <0.0001; I2 = 45.9%

Not recorded as a finding: this platform holds no node for the endpoint

The pooled results showed that acetaminophen use during pregnancy increased the risk of ASD diagnosis by 18% (OR 1.18, 95% CI 1.15 to 1.32, p <0.0001; I2 = 45.9%).

PMID:42500177 · one of two readings recorded this

Autism spectrum symptoms (CAST or similar screening scores)

increases, OR 1.16, 95% CI 0.94 to 1.43, p = 0.1719, I2 = 0% (not statistically significant)

A higher risk of presenting ASD symptoms by 16% was observed, albeit not statistically significant (OR 1.16, 95% CI 0.94 to 1.43, p= 0.1719, I2 = 0%) and with no substantial heterogeneity in the sensitivity analysis (Supplemental material: Figure S2).

PMID:42500177 · one of two readings recorded this