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PPIs Raise Pneumonia Risk in Older Adults

Proton pump inhibitors (PPIs) may be associated with an increased risk of community-acquired pneumonia during the second year of use among older adults, according to a new study.
For their study, the researchers evaluated 75,050 PPI recipients aged 60 years or older, along with 75,050 sex-matched controls.
The prior event rate ratio (PERR) was used to estimate net hazard ratios for pneumonia incidence during year 2 of treatment, and inverse probability weighted models adjusted for 78 demographic, disease, medication, and healthcare usage measures.
Findings of the study demonstrated that PPI use was associated with a greater risk of incident pneumonia (PERR-adjusted hazard ratio 1.82) during the second year after initiating treatment. The researchers noted that these results accounted for pretreatment pneumonia rates.
Similar estimates were calculated between age and comorbidity subgroups, and similar findings were observed in propensity score- and inverse probability-weighted models.
“In a large cohort of older adults in primary care, PPI prescription was associated with greater risk of pneumonia in the second year of treatment,” the researchers concluded. “Results were robust across alternative analysis approaches.”
“Controversies about the validity of reported short?term harms of PPIs should not divert attention from potential long?term effects of PPI prescriptions on older adults,” they added.

REFERENCE:
Zirk-Sadowski J, Masoli JA, Delgado J, et al. Proton-pump inhibitors and long-term risk of community-acquired pneumonia in older adults [Published online April 20, 2018]. J Am Geriatr Soc.

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