Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Roberts E

PROVIDER: S-EPMC4789700 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Publications

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

Roberts Emmert E Delgado Nunes Vanessa V Buckner Sara S Latchem Susan S Constanti Margaret M Miller Paul P Doherty Michael M Zhang Weiya W Birrell Fraser F Porcheret Mark M Dziedzic Krysia K Bernstein Ian I Wise Elspeth E Conaghan Philip G PG

Annals of the rheumatic diseases 20150302 3

<h4>Objectives</h4>We conducted a systematic literature review to assess the adverse event (AE) profile of paracetamol.<h4>Methods</h4>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 Eval ...[more]

PMID: 25732175

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Dataset Information

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

Objectives

Methods

Results

Discussion

Publications

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

Similar Datasets

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