مراجعة

Paracetamol: not as safe as we thought? A systematic literature review of observational studies

التفاصيل البيبلوغرافية
العنوان: Paracetamol: not as safe as we thought? A systematic literature review of observational studies
المؤلفون: Roberts E, Nunes VD, Buckner S, Latchem S, Constanti M, Miller P, Doherty M, Zhang WY, Birrell F, Porcheret M, Dziedzic K, Bernstein I, Wise E, Conaghan PG
المصدر: Annals of the Rheumatic Diseases
بيانات النشر: BMJ PUBLISHING GROUP
المجموعة: Newcastle University Library ePrints Service
الوصف: Objectives We conducted a systematic literature review to assess the adverse event (AE) profile of paracetamol.Methods We searched Medline and Embase from database inception to 1 May 2013. We screened for observational studies in English, which reported mortality, cardiovascular, gastrointestinal (GI) or renal AEs in the general adult population at standard analgesic doses of paracetamol. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation. Pooled or adjusted summary statistics were presented for each outcome.Results Of 1888 studies retrieved, 8 met inclusion criteria, and all were cohort studies. Comparing paracetamol use versus no use, of two studies reporting mortality one showed a dose-response and reported an increased relative rate of mortality from 0.95 (0.92 to 0.98) to 1.63 (1.58 to 1.68). Of four studies reporting cardiovascular AEs, all showed a dose-response with one reporting an increased risk ratio of all cardiovascular AEs from 1.19 (0.81 to 1.75) to 1.68 (1.10 to 2.57). One study reporting GI AEs reported a dose-response with increased relative rate of GI AEs or bleeds from 1.11 (1.04 to 1.18) to 1.49 (1.34 to 1.66). Of four studies reporting renal AEs, three reported a dose-response with one reporting an increasing OR of >= 30% decrease in estimated glomerular filtration rate from 1.40 (0.79 to 2.48) to 2.19 (1.4 to 3.43).Discussion Given the observational nature of the data, channelling bias may have had an important impact. However, the dose-response seen for most endpoints suggests a considerable degree of paracetamol toxicity especially at the upper end of standard analgesic doses.
نوع الوثيقة: review
وصف الملف: application/pdf
اللغة: unknown
الإتاحة: https://eprint.ncl.ac.uk/fulltext.aspx?url=223122/BF15C2F6-F01E-485C-8FF5-D70A0670629D.pdf&pub_id=223122Test
رقم الانضمام: edsbas.89720EEA
قاعدة البيانات: BASE