Heartburn drugs linked to pneumonia in older people

"For each 420 people treated with a proton pump inhibitor, which reduces stomach acid production, there will be 1 excess case of pneumonia," said Dr. Jane Masoli, a researcher at the University of Exeter.
By Allen Cone  |  April 25, 2018 at 10:01 AM
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April 25 (UPI) -- Commonly used heartburn drugs have been statistically linked to pneumonia in people 60 years and older, according to a study conducted in Britain.

Researchers at the University of Exeter Medical School studied the effects of proton-pump inhibitors, which are used to treat reduce gastric acid production and to protect the stomach. Their findings were published this month in the Journal of the American Geriatrics Society.

Widely-used PPIs include Prilosec, Nexium, Prevacid and Dexilent. Another commonly used heartburn medication, Zantac, is not a PPI, but a histamine-2 blocker.

Previous studies have shown that roughly 40 percent of older adults receive the drugs, but that 85 percent of those people may not need them.

"The study results show that for each 420 people treated with a proton pump inhibitor, which reduces stomach acid production, there will be 1 excess case of pneumonia," Dr. Jane Masoli, a researcher in the Epidemiology and Public Health Group at the University of Exeter Medical School, told UPI. "This research is not able to make conclusions as to why this is the case. We have shown for the first time that the increased risk in pneumonia is present when proton pump inhibitors are used longer term."

PPIs also have more recently been linked to increased rates for other concerns, including fractures, cardiovascular disease and some bacterial infections. The researchers said PPI use and pneumonia was studied because stomach acid helps to prevent infections from the gut in some individuals.

The researchers analyzed information from Clinical Practice Research Datalink for England, which contains records from many primary care practices in Britain from the last 30 years. For the study, they used the proton pump inhibitor start date, records from two years before the initial prescription and records from two years after initial prescription.

The researchers identified 75,050 people who were 60 years and older and had taken the medication, matching them with a control group of 75,050 people who had not taken a PPI.

They said people should not necessarily stop using PPI medications as a result of the study, but instead discuss it with a healthcare professional.

While PPIs are effective at reducing stomach acid, preventing stomach ulcers and symptoms of gastro-esophageal reflux disease, Masoli said the problem is that some patients are started on the drugs for a specific reason but continue to take them long beyond when they are needed.

She also said that, in addition to a significant body of work showing that short-term risk of pneumonia is raised with PPI prescriptions, the new study showed a rise in pneumonia before prescription -- which may describe differences in patients who receive the drugs.

"Further work is needed to clarify these differences in prescribing," Masoli said, adding that "clinicians and patients should always ensure that medications being taken regularly have adequate indication and weigh up risks versus benefits on an individual basis."

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