The study triggered further headlines when a Cochrane blog revisited paracetamol’s effectiveness. Writing for Evidently Cochrane in August 2016, leading analgesics researcher Professor Andrew Moore said:

“A Cochrane review is unequivocal – it doesn’t work. Not immediately, not later. At no stage between one and 12 weeks is 4,000mg daily any better than a placebo. Nor does the review find any evidence that it works in chronic back pain either.”¹⁰

He also noted that the most recent data on paracetamol use in osteoarthritis indicates the drug has a “barely significant and tiny benefit” compared to placebo, and “ranks barely above placebo in a network meta-analysis”. Furthermore: “For chronic neuropathic pain an ongoing Cochrane review reveals a complete lack of any evidence for paracetamol at all. Paracetamol is without effect in cancer pain, and it is the poor relation in acute postoperative pain and migraine.”

Turning to safety, Prof Moore’s article refers to other research, indicating:

• Increased mortality in cardiovascular and gastrointestinal events and renal impairment
• Increased risk of acute liver failure associated with non-overdose levels of paracetamol compared to NSAIDs 
• A four times increased risk of abnormal liver function tests among people taking paracetamol for chronic pain 
• Similar adverse event rates for paracetamol and ibuprofen over three months when taken for arthritis.