Acid-suppressive medications in infancy associated with food allergy risks

Key takeaways:

• Acid-suppressive therapy has been linked with gut dysbiosis.
• Proton pump inhibitors presented the highest risks.
• Risks for anaphylaxis, atopic dermatitis and allergic rhinitis were similar.

WASHINGTON — Infants who were exposed to acid-suppressive medications had increased risk for developing food allergy, according to an abstract presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

Risks also increased for anaphylaxis, atopic dermatitis and allergic rhinitis, Julia Tanzo, BS, student at the Cleveland Clinic Lerner College of Medicine, and colleagues wrote.

“We found that early exposure to acid-suppressive medications was associated with five to six times higher risk of food allergy and anaphylaxis, with similar trends observed for antimicrobials,” Tanzo said in a press release.

Noting that acid-suppressive therapy has been associated with gut dysbiosis, which itself has been implicated in allergy development, the researchers hypothesized that these medications may increase the risks for allergy.

The researchers identified 56,492 patients in the TriNetX platform’s United States network who had been prescribed proton pump inhibitors (PPIs) before age 1 year between January 2015 and July 2021.

Also, 168,909 patients had received prescriptions for histamine-2 receptor antagonists during their first year of life, 886,746 had been prescribed one or more antimicrobials and 216,009 were prescribed three or more antimicrobials.

The researchers examined whether food allergy, anaphylaxis, atopic dermatitis or allergic rhinitis emerged in the following 2 years.

Risk ratios for food allergy included 6.41 (95% CI, 6.18-6.64) with PPI prescriptions, 2.32 (95% CI, 2.27-2.37) with one or more antimicrobial prescriptions and 2.93 (95% CI, 2.84-3.02) for three or more antimicrobial prescriptions.

Similarly, risk ratios for anaphylaxis, atopic dermatitis and allergic rhinitis with these medications ranged from 2.17 to 11.23 (95% CI, 2.1-2.25 to 10.87-11.61).

These findings could guide physicians in determining better options for patient care and in disclosing risks when they prescribe these medications, the researchers said.

“We hope that this association study will motivate future studies on the mechanisms underlying our findings and the role of potential confounding factors,” Tanzo said.

References:

• Acid-suppressive medication and antimicrobial use in infancy associated with food allergy and anaphylaxis. https://www.aaaai.org/about/news/news/2024/acid-suppressive. Published Feb. 5, 2024. Accessed March 18, 2024.
• Tanzo J, et al. J Allergy Clin Immunol. 2024;doi:10.1016/j.jaci.2023.11.832.