High-Dose Ibuprofen in Cystic Fibrosis: Canadian Safety and Effectiveness Trial

Objective

To assess the effectiveness and safety of high-dose ibuprofen when used as part of routine therapy in patients with cystic fibrosis (CF).

Study design

In this multicenter, double-blinded, placebo-controlled trial, a total of 142 patients age 6 to 18 years with mild lung disease (forced expiratory volume in 1 minute [FEV₁] > 60 predicted) were randomized to receive either high-dose ibuprofen (70 subjects, 20 to 30 mg/kg/twice daily, adjusted to a peak serum concentration of 50 to 100 μg/mL) or placebo (72 subjects) for a 2-year period. The primary outcome was the annualized rate of change in FEV₁% predicted.

Results

The patients in the high-dose ibuprofen group exhibited a significant reduction in the rate of decline of forced vital capacity percent predicted (0.07 ± 0.51 vs –1.62 ± 0.52; P = .03), but not FEV₁%. The ibuprofen group also spent fewer days in hospital after adjusting for age (1.8 vs 4.1 days per year; P = .07). A total of 11 patients (4 in the ibuprofen group and 7 in the placebo group) withdrew due to adverse events.

Conclusions

High-dose ibuprofen has a significant effect on slowing the progression of lung disease in CF and generally is well tolerated.

Abbreviations: ACTG, AIDS Clinical Trial Group, CF, Cystic fibrosis, FEV₁, Forced expiratory volume in 1 minute, FVC, Forced vital capacity