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Ibuprofen was effective in preventing high altitude
headaches; could be used as an alternative to acetazolamide or dexamethasone.
Based on a limited number of studies ibuprofen seems efficacious
for the prevention of HAH and may, therefore, represent an alternative for
preventing HAH with acetazolamide or dexamethasone. HAH is one of the common
forms of a headache which occurs at high altitude, generally over 3000 meters
above the sea level. It is a neurological problem in which cellular hypoxia
occurs due to low barometric pressure at height. Most of the HAH known to
respond to pain relief medicines such as paracetamol or ibuprofen. However,
ibuprofen use in HAH prevention is still unclear.
Therefore, to evaluate ibuprofen efficacy in managing HAH, scientists conducted
a systematic review and meta-analysis of randomised, placebo-controlled trials
(RCTs). Electronic database until 2016 was used to evaluate studies that
reporting ibuprofen efficacy in HAH prevention. Total three
randomised-controlled clinical trials involved in the research, which contained
407 participants. These participants differentiated into two groups, 239
received ibuprofen and left 168 received placebo. In the ibuprofen group, 101
cases showed HAH, and in the placebo group, 96 showed HAH. The absolute risk
reduction (ARR) noticed among them was 15%, and the number needed to treat
(NNT) to prevent HAH was 7.
Moreover, the HAH prevalence was significant in both the groups. During analysis, the primary outcome which evaluated was the difference in the incidence of HAH between ibuprofen and placebo groups. The risk ratios were also assessed by using a Mantel-Haenszel random effect model. Further, I2 statistics were also involved in the study to evaluate the heterogeneity of included trials.
After treatment, the cases of HAH occurred among ibuprofen was 3% and 10% in
placebo. The prevalence of ARR was 8%, and the NNT was 13. However, the
severity of a headache was not different between both the group, measured by
using a visual analogue scale. No difference in the change in SpO2 from baseline to altitude was seen after
treatment. Further, amid the ibuprofen group, three participants suffered from
stomach pain and one with black stools. The placebo group showed seven cases of
stomach pain.
PLoS One. 2017 Jun 20;12(6):e0179788.
Efficacy of ibuprofen on prevention of high altitude headache: A systematic review and meta-analysis.
Juan Xiong et al.
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