Le dilemme du paracétamol

WELLINGTON – Le paracétamol (aussi connu sous le nom d’acétaminophène) est le médicament le plus communément utilisé au monde. Son innocuité en fait le préféré pour soulager douleurs et fièvres. Or, on a avancé il y a dix ans qu’il pourrait accroître les risques d’asthme. Cette hypothèse suppose qu’avoir donné du paracétamol plutôt que de l’aspirine aux enfants aux Etats-Unis durant les années 1980 aurait contribué à la prévalence d’asthme infantile en hausse à cette époque.

La substitution de l’aspirine par le paracétamol conduirait, d’après les recherches, à une réponse immunitaire allergique plus prononcée, augmentant de ce fait la susceptibilité à l’asthme et à d’autres allergies. Diverses études épidémiologiques ont depuis dégagé un lien entre l'asthme et une exposition au paracétamol dans l’utérus, durant l’enfance et l’adolescence. En fin de compte, ces études suggèrent que l’usage du paracétamol constituerait un facteur de risque important dans l’apparition de l’asthme.

Les résultats d’une étude épidémiologique d’envergure internationale sur l’asthme infantile récemment publiée dans la revue médicale The Lancet viennent corroborer cette hypothèse. L’analyse, faite par l’International Study of Asthma and Allergies in Childhood (ISAAC, Centre d’étude international sur l’asthme et les allergies infantiles) portait sur plus de 200�000 enfants âgés de six et sept ans dans 73 centres de 31 pays. Les parents ou tuteurs ont répondu à un questionnaire écrit sur les symptômes actuels de l'asthme, de la rhinite (rhume des foins) et de l’eczéma, et sur d’autres facteurs de risques, y compris l’usage du paracétamol pour soulager la fièvre d’un enfant de moins de 12 mois et la fréquence de la prise de paracétamol au cours des 12 derniers mois.

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