News briefs

Paracetamol may be linked to asthma in some children

Children who take paracetamol during their first 2 years of life may be at a higher risk of developing asthma by the age of 18, especially if they have a particular genetic makeup, according to research led by the University of Melbourne and presented at the international congress of the European Respiratory Society in Paris. The investigators analysed data for 620 children who had been followed from birth to 18 years of age as part of the Melbourne Atopy Cohort Study. The children had been recruited to the study before birth because they were considered to be at high risk of an allergy-related disease because at least one family member (mother, father or sibling) had a self-reported allergic disease (asthma, eczema, hay fever, or a severe food allergy). After their birth, a research nurse rang the family every 4 weeks during the first 15 months, and then at 18 months and at 2 years to ask how many days in the preceding weeks had the child had been given paracetamol. When the children were 18 years old, a blood or saliva sample was collected and tested for variants of the glutathione S-transferase genes, GSTT1, GSTM1 and GSTP1. They were also assessed for asthma, and a spirometry test undertaken. One variant of the GSTP1 gene, GSTP1 Ile/Ile, was associated with a higher risk of developing asthma. “Our findings provide more evidence that paracetamol use in infancy may have an adverse effect on respiratory health for children with particular genetic profiles and could be a possible cause of asthma. There is mounting evidence that the GST superfamily of genes, including three major classes — GSTM1, GSTT1 and GSTP1 — are associated with various diseases, including cancers, asthma, atherosclerosis, allergies, Alzheimer’s and Parkinson’s disease. Our study adds to this body of evidence,” the authors noted.

https://erscongress.org/

https://academic.oup.com/ije/article/46/1/25/2617155

An aspirin a day won’t help you live longer

A major 7-year Australian trial published in the New England Journal of Medicine found that taking daily aspirin did not prolong life free of disability, nor did it significantly reduce the risk of a first heart attack or stroke. The ASPREE (ASPirin in Reducing Events in the Elderly) trial, including more than 19 000 participants in Australia and the United States, is the largest and most comprehensive study to examine whether the many millions of older people around the world who take low dose aspirin (100 mg) to preserve good health are receiving any benefit. According to principal investigator Professor John McNeil, head of the Monash University Department of Epidemiology and Preventive Medicine, the results of the trial mean that global guidelines on the use of aspirin for preventing common ageing-related conditions need to be re-examined. ASPREE also found that the rate of major haemorrhage was higher for aspirin-takers than for those receiving placebo (8.6 v 6.2 events per 1000 person-years; hazard ratio, 1.38; 95% CI, 1.18–1.62). Bleeding is recognised as a side effect of aspirin, particularly in older people. “It means millions of healthy older people around the world who are taking low dose aspirin without a medical reason, may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding.” Professor McNeil said all patients should follow the advice of their doctor about their daily use of aspirin. He cautioned that the results do not apply to those with existing conditions such as a previous heart attack, angina or stroke, for whom aspirin is a valuable preventive drug.

https://www.nejm.org/doi/full/10.1056/NEJMoa1805819