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Asthma study aided by Pitt, Allegheny Health eyes acetaminophen link

| Saturday, Feb. 15, 2014, 9:00 p.m.
Guy Wathen | Pittsburgh Tribune-Review
Dr. David P. Skoner, division director in allergies and immunology for the Allegheny Health Network, displays preventative asthma inhalers in his office on January 20, 2014.
Justin Merriman | Tribune-Review
Dr. David Skoner sits in an exam room of Allegheny General Hospital's Professional Building on the North Side on Tuesday, Feb. 11, 2014. Researchers are looking into new asthma research that tries to examine whether Tylenol can exacerbate asthma symptoms in children.
Guy Wathen | Pittsburgh Tribune-Review
Dr. David P. Skoner, division director in allergies and immunology for the Allegheny Health Network, is the co-director of a Heinz Endowments-funded study that will examine what’s influencing the number of childhood asthma cases in the Pittsburgh area.
Guy Wathen | Pittsburgh Tribune-Review
Dr. David P. Skoner, division director in allergies and immunology for the Allegheny Health Network, displays preventative asthma inhalers in his office on January 20, 2014.

Dr. John McBride won't recommend Tylenol for anyone with asthma. He says it's just too risky because of a potential link between Tylenol's active drug — acetaminophen — and severe breathing difficulty, especially in asthmatic children.

“I don't think the entire asthma epidemic is due to Tylenol. But I think it may have significantly contributed,” said McBride, a vice chairman at Akron Children's Hospital in Ohio who found “incredible consistency” in reported patterns of acetaminophen use and bad asthma symptoms. “I just think it's important for people to realize that acetaminophen is likely to be bad for kids with asthma.”

How likely is the key question in a government-backed study that the University of Pittsburgh, Allegheny Health Network and doctors in a dozen other U.S. cities will lead during the next two years. It's the latest research trying to explain a three-decade boom in the reported severity and prevalence of pediatric asthma, which afflicts about one in 10 children, according to the Centers for Disease Control and Prevention.

Roughly 8 percent of people in the United States have the respiratory disease, up from 7 percent over the past 13 years, according to the CDC.

“Acetaminophen use skyrocketed, and so did asthma. Some people think acetaminophen use caused that asthma. Others feel that a lack of aspirin has done that,” said Dr. David P. Skoner, the Allegheny Health division director in allergy and immunology. “Nobody knows if it (acetaminophen) is causal or not.”

Skoner will join researchers at Pitt's Asthma Institute and Case Western Reserve University in Cleveland to observe 33 children with asthma, said Dr. Fernando Holguin, assistant director at the Asthma Institute. He said the study, prompted by the national AsthmaNet research network and funded by the National Institutes of Health, will compare respiratory symptoms in those who take ibuprofen as a painkiller with those who take acetaminophen.

“They both could be safe for all we know,” Holguin said.

Montgomery County-based McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that supplies Tylenol, said no “prospective, randomized controlled studies” illustrate a causal link between acetaminophen and asthma.

“Tylenol has more than 50 years of clinical use to support its safety and efficacy and, when used as directed, Tylenol has one of the most favorable safety profiles among over-the-counter pain relievers,” the company said in a written statement.

The suggestion that Tylenol might worsen asthma symptoms startled Cathy Cook, 41, of Bethel Park, whose family has participated in other asthma studies at Allergy and Clinical Immunology Associates in Upper St. Clair . She has given her daughter Morgan, 12, who has asthma, doses of Tylenol to control fevers.

“It's crazy to think that even could be related,” Cook said. “Here I was trying to bring her fever down, and now they're thinking I could have been making it worse.”

She said at least 80 percent of Morgan's young friends and acquaintances have asthma or some other allergy. Asthma patients can experience wheezing, coughing and disrupted breathing patterns.

“I'm hopeful when we participate (in research) that we're getting to a safer and better treatment or cure. That's why we participate,” Cook said.

Allegheny Health last month announced a $415,000 grant from the Heinz Endowments that will help doctors identify more precise childhood asthma rates and triggers for the disease in the Pittsburgh area. School nurses estimate as many as half of Pittsburgh Public Schools students live with asthma.

Adam Smeltz is a staff writer for Trib Total Media. He can be reachedat 412-380-5676 or asmeltz@tribweb.com.

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