"Contrary to earlier reports giving acetaminophen Tylenol etc. for pain and fever does not worsen asthma in young children with the condition concludes a randomized trial in the August  New England Journal of Medicine.  The Acetaminophen Versus Ibuprofen in Children with Asthma AVICA trial led by researchers at Boston Childrens Hospital for the National Heart Lung and Blood Institutes Asthma Network AsthmaNet is the only blinded randomized controlled trial to date to prospectively compare acetaminophen headtohead with ibuprofen Motrin etc. in children with asthma. The site study should settle a debate that originated when several retrospective studies seemed to indicate that children had exacerbations of their asthma when receiving Tylenol for pain andor fever. We found no matter how you slice it there was absolutely no difference between Tylenol and Motrin says senior investigator and corresponding author Wanda Phipatanakul MD MS of Boston Childrens Hospitals Division of Allergy and Immunology. Our findings should alleviate the concerns for safety that were based on observational data. The study enrolled  children  to  years old with mild persistent asthma. Their families were randomized to use either acetaminophen or ibuprofen as indicated for pain and fever over a week period.  Both groups received the same asthma control therapies daily inhaled glucocorticoids as needed inhaled glucocorticoids and daily oral leukotriene receptor antagonist. The asthma therapies were given in varying order as part of a concurrent randomized trial making this in effect a trial within a trial. Medication adherence was closely monitored. Of the original  children   percent completed the study. Children in the acetaminophen and ibuprofen groups used similar amounts of these medications for pain andor fever median . doses.  During the  weeks there were no statistically significant differences between groups  The number of asthma exacerbations per child averaged . in the acetaminophen group versus . in the ibuprofen group.   At least one asthma exacerbation occurred in  percent of the acetaminophen group vs.  percent of the ibuprofen group. At least two episodes occurred in  and  percent respectively.   The percentage of days with full asthma control were virtually the same for acetaminophen and ibuprofen . and . percent respectively.  Use of rescue medication albuterol was essentially the same . vs. . puffs per week.  Unscheduled healthcare visits for asthma were equivalent averaging . vs. . episodes per child. While the study was modest in size it was powered to detect any clinically significant differences more so than past retrospective studies Phipatanakul notes. There was no difference that would cause me to be alarmed she says. The researchers note that earlier studies linking acetaminophen with increased asthma symptoms did not use a randomized design. Those studies therefore couldnt rule out the possibility that the asthma exacerbations were caused by the respiratory infections themselves. The toddler age is a wheezy age when kids are developing asthma but they also get a lot of fevers and colds says Phipatanakul. Without a randomized design its hard to tease out the effects of medications. Since the study was limited to young children with mild persistent asthma receiving asthma controller therapy the authors also note that their findings may not apply to other age groups or children with more severe asthma. Further studies will be necessary to answer those questions. William J. Sheehan MD of Boston Childrens Hospital was first author on the paper. The study was funded by The National Heart Lung and Blood Institutes Asthma Network AsthmaNet and grants from the National Institutes of Health HL HL HL HL HL HL HL HL HL HL TR TR TR TR KAI and KAI. About Boston Childrens Hospital  Boston Childrens Hospital is home to the worlds largest research enterprise based at a pediatric medical center where its discoveries have benefited both children and adults since . More than  scientists including seven members of the National Academy of Sciences  members of the Institute of Medicine and  members of the Howard Hughes Medical Institute comprise Boston Childrens research community. Founded as a bed hospital for children Boston Childrens today is a bed comprehensive center for pediatric and adolescent health care. Boston Childrens is also the primary pediatric teaching affiliate of Harvard Medical School. For more visit our Vector and Thriving blogs and follow us on our social media channels BostonChildrens http BCH_Innovation http_Innovation Facebook and YouTube."