Association Between Proton Pump Inhibitor Use and Risk of Asthma in Children

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Wang, Yun-HanKarolinska Institutet (författare)

Association Between Proton Pump Inhibitor Use and Risk of Asthma in Children

Artikel/kapitelEngelska2021

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American Medical Association,2021
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LIBRIS-ID:oai:DiVA.org:oru-90415
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-90415URI
https://doi.org/10.1001/jamapediatrics.2020.5710DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:145969471URI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies:Frimurare Barnhuset Foundation Strategic Research Area Epidemiology program at Karolinska Institutet
IMPORTANCE: The use of proton pump inhibitors (PPIs) in children has increased substantially in recent years, concurrently with emerging concerns that these drugs may increase the risk of asthma. Whether PPI use in the broad pediatric population is associated with increased risk of asthma is not known.OBJECTIVE: To investigate the association between PPI use and risk of asthma in children.DESIGN, SETTING, AND PARTICIPANTS: This nationwide cohort study collected registry data in Sweden from January 1, 2007, to December 31, 2016. Children and adolescents 17 years or younger were matched by age and propensity score into 80 870 pairs of those who initiated PPI use and those who did not. Data were analyzed from February 1 to September 1, 2020.EXPOSURES: Initiation of PPI use.MAIN OUTCOMES AND MEASURES: The primary analysis examined the risk of incident asthma with a median follow-up to 3.0 (interquartile range, 2.1-3.0) years. Cox proportional hazards regression was used to estimate hazard ratios (HRs).RESULTS: Among the 80 870 pairs (63.0% girls; mean [SD] age, 12.9 [4.8] years), those who initiated PPI use had a higher incidence rate of asthma (21.8 events per 1000 person-years) compared with noninitiators (14.0 events per 1000 person-years), with an HR of 1.57 (95% CI, 1.49-1.64). The risk of asthma was significantly increased across all age groups and was highest for infants and toddlers with an HR of 1.83 (95% CI, 1.65-2.03) in the group younger than 6 months and 1.91(95% CI, 1.65-2.22) in the group 6 months to younger than 2 years (P < .001for interaction). The HRs for individual PPIs were 1.64 (95% CI, 1.50-1.79) for esomeprazole, 1.49 (95% CI, 1.25-1.78) for lansoprazole. 1.43 (95% CI, 1.35-1.51) for omeprazole, and 2.33 (95% CI, 1.30-4.18) for pantoprazole. In analyses of the timing of asthma onset after PPI initiation, the HRs were 1.62 (95% Cl. 1.42-1.85) for 0 to 90 days, 1.73 (95% CI, 1.52-1.98) for 91to 180 days. and 1.53 (95% CI, 1.45-1.62) for 181days to end of follow-up. The association was consistent through all sensitivity analyses, including high-dimensional propensity score matching (HR, 1.48; 95% CI, 1.41-1.55).CONCLUSIONS AND RELEVANCE: In this cohort study, initiation of PPI use compared with nonuse was associated with an increased risk of asthma in children. Proton pump inhibitors should be prescribed to children only when clearly indicated, weighing the potential benefit against potential harm.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Wintzell, ViktorKarolinska Institutet (författare)
Ludvigsson, Jonas F.,1969-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, United Kingdom; Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA(Swepub:oru)jsln (författare)
Svanström, HenrikKarolinska Institutet (författare)
Pasternak, BjörnKarolinska Institutet (författare)
Karolinska InstitutetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Sammanhörande titlar

Ingår i:JAMA pediatrics: American Medical Association175:4, s. 394-4032168-62032168-6211

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Av författaren/redakt...: Wang, Yun-Han; Wintzell, Viktor; Ludvigsson, Jona ...; Svanström, Henri ...; Pasternak, Björn

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Pediatrik

Artiklar i publikationen: JAMA pediatrics

Av lärosätet: Örebro universitet; Karolinska Institutet

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