This is surprising news for anyone who has ever considered using acetaminophen, which by its name means “oxygen” in its formulation. Doctors have long believed that by taking medications, one is limiting the damage caused by breathing in ozone and regular exposure to severe, short-term exposures, when the problem comes on fast. But a new study published Friday in The BMJ shows the opposite – that taking acetaminophen during asthma can boost asthma symptoms.
Asthma is an asthma-causing illness that attacks the airways and symptoms that accompany coughing, breathing, etc.
It is closely linked to poor health and wellbeing; it is responsible for deducting about 25% of UK health spending from the national average of health and social care costs. It is also one of the first to be linked to the use of hydroxychloroquine, a medication used in combination with non-steriodic drugs and which White House scientific adviser Eric J Cordaini, PhD, said had “a considerably stronger effect” than usual daily treatment.
This trial was conducted via a register-funded observational study of 40 seriously ill patients (91% male, average age 42 years) in the UK between December 2014 and December 2017. Patients were randomly assigned to either hydroxychloroquine or usual care (placebo) at the outset of the trial. The trial ended when the data came back, with over a third of the 40 patients still (82%) still being on the medication.
The investigators found that allyl hydroxychloroquine comprised the most (12.4% of the total pill group) and significantly was also associated with a significantly higher incidence of shortness of breath (6.3% of the total dose), asthmatic cough (7.8% of the total dose), and wheezing (7.6% of the total dose) compared to placebo (3.1% of the total dose). It was also associated with more asthma episodes (18.1% of the total dose), lower interstitial ciliary pressure (9.9% of the total dose), and a lower average blood pressure (BP) reading (7.4% of the total dose).
No difference was found in other asthma outcomes, including breathlessness at rest (7.6% of the total dose) and wheezing frequency (7.0% of the total dose). No drug interaction was found with a single dose of hydroxychloroquine and no day-to-day side effects were found.
Study authors acknowledge that it is not clear at this stage – after follow-up of a year – whether the dose-busting effects of the drug have actually reached moderate to moderate levels of efficacy, and whether the drug may be more useful at this stage of the disease than if it is switched off altogether. But they add that further human analyses with patients still on hydroxychloroquine are needed before they can confidently say that the effect seen in the clinical trial has sustained the abating effect, and they add that “the next step in the search for ‘flavors’ which might make the drug useful in asthma and the management of asthma exacerbations is’ with larger trials with more participants, and even a phase 3 trial of the drug.
The Cochrane Prescribing Information Systematic Reviews Database, published in 2015 and 2016, is a repository of data for existing randomized clinical trials involving asthma medicines. From that analysis, codeine (AT)-containing oral products were identified within this trial database and hydroxychloroquine was identified in other trial databases.
The trial was conducted in 24 intensive care unit units in the UK National Health Service. The minimum age of patients was 55 years; the mean age (range, 52 to 84) was 73 years. The trial involved 732 patients from 9 general and 6 linked asthma centres in the UK with the intention to enroll in a double-blind placebo-controlled placebo-controlled trial.
Research was funded by the Medical Research Council, UK Research and Innovation Fund Programme, and Asthma UK. Dr. Cordaini said: “We now now need large-scale human clinical trials of these novel medicines to confirm the effectiveness of daily oral agents and larger-scale human trials to test the reliability of these agents in asthma and identify which are likely to promise the best outcome for asthma patients. The evidence of efficacy and safety of long-term improvements in asthma and worsening of asthma exacerbations in patients taking Atypical Linezolid, and other prescribed A has not yet been reviewed.”