This study aimed to assess the efficacy, safety, and cost-effectiveness of ibuprofen and acetaminophen for managing fever in children with asthma, providing evidence-based guidance for clinical decision-making and treatment regimen selection. A rapid health technology assessment approach was employed. Following a comprehensive literature search of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, official websites, and relevant health technology assessment databases, the retrieved studies were screened, and data were extracted and evaluated for quality. A total of nine studies were included, comprising two reviews, five systematic reviews/meta-analyses (SRs/MAs), one randomized controlled trial, and one health technology assessment report. Regarding efficacy, combined or alternating therapy demonstrated superior temperature reduction compared with monotherapy, resulting in a lower proportion of children remaining febrile and a longer afebrile period after 4 h. Within the initial 4-hour window, ibuprofen monotherapy was more effective than acetaminophen monotherapy. In terms of safety, the overall incidence of adverse drug reactions was comparable across combined therapy, alternating therapy, and monotherapy; however, the included studies reported inconsistent findings concerning the risk of asthma onset or exacerbation. Concerning cost-effectiveness, although specific analyses in asthmatic populations were lacking, evidence from the United Kingdom indicated that, from the perspective of the National Health Service, combined therapy was more cost-effective than monotherapy in reducing fever, whereas from the parental perspective, this advantage emerged only after 5 d of treatment. Overall, compared with monotherapy, combined and alternating therapies exhibit greater efficacy in treating fever in children with asthma; nonetheless, further high-quality studies are warranted to clarify their safety profile and cost-effectiveness.
>
>