PPIs linked to acute gastroenteritis in winter
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During the winter months, when the circulation of enteric viruses is at its highest, continuous use of proton pump inhibitors are associated with increased risk for developing acute gastroenteritis, according to study results published in JAMA Network Open.
Ana-Maria Vilcu, MSc, of Sorbonne University in Paris, and colleagues wrote that previous studies have found a link between PPIs and infection, but the association between PPIs and acute gastroenteritis (AGE) is not as well defined.
“In the temperate northern hemisphere, peaks of AGE activity are observed every winter,” they wrote. “They are mainly caused by infections with enteric viruses. This study aimed to investigate the association between continuous PPI exposure and the occurrence of AGE during winter epidemics when the circulation of enteric viruses is the highest.”
Researchers performed a matched cohort study using data from a prospectively collected drug dispensing database from community pharmacies in France. They matched patients exposed to PPIs during the 2015–2016 winter season (n = 233,596) with patients not exposed to PPIs (n = 626,887). They identified episodes of AGE using a previously validated algorithm based on drug dispensing data.
Investigators identified at least one episode of AGE in 3,131 patients exposed to PPIs (1.3%) and in 4,327 patients not exposed (0.7%).
The adjusted relative risk for AGE was highest among individuals aged 65 to 74 years (aRR = 2.19; 95% CI, 1.98–2.42), followed by patients aged 75 years and older (aRR = 1.98; 95% CI, 1.82–2.15) and patients aged 45 to 64 years (aRR = 1.66; 95% CI, 1.54–1.8).
“Associations such as those reported in this study are yet another reason to reexamine unnecessary and non-evidence-based indications for PPI therapy,” Vilcu and colleagues wrote. “As regions head into enteric viral infection season, this would be an opportune time to reassess the ongoing need for PPI therapy in patients, especially older adults, and potentially deprescribe.” – by Alex Young.
Disclosures: The authors report no relevant financial disclosures.
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