In the Journals

Reflux drugs linked to long-term pneumonia risk in elderly

People older than 60 years who took proton pump inhibitors long-term showed an increased risk for developing pneumonia, according to new research published in the Journal of the American Geriatrics Society.

“This study shows that there was a higher rate of pneumonia in older people who received PPIs over a two-year period,” David Melzer, MBBCh, PhD, professor of epidemiology and public health at the University of Exeter Medical School in the U.K said in a press release. “Caution is needed in interpreting the findings as our study is based on analyzing data from medical records, so other factors may be involved. However, our study adds to growing evidence that PPIs are not quite as safe as previously thought, although they are still a very useful class of medication for certain groups of patients.”

To evaluate for a connection between long-term PPI use and the incidence of pneumonia among older adults in the primary care setting, Melzer and colleagues reviewed the electronic medical records of 75,050 patients aged older than 60 years who took PPIs for at least a year and compared them with an equal number of controls matched by age and sex.

After adjusting for pneumonia incidence before initiation of treatment, they found a statistical association between long-term PPI use and incident pneumonia during the second year of treatment (prior event rate ratio (PERR)-adjusted HR = 1.82; 95% CI, 1.27-2.54). They saw similar results across subgroups based on age and comorbidity, and in alternative analysis models.

“Pneumonia risk is greater with long-term PPI therapy in older adults in primary care, independent of excess pneumonia rates immediately before first PPI receipt,” Meltzer and colleagues concluded. “In our cohort, the excess risk was statistically similar across age and comorbidity groups, but more work is needed to identify individuals at highest risk.” – by Adam Leitenberger

Disclosures: One of the authors reports he is a former employee of Pfizer and is currently employed by Alfasigma.

 

People older than 60 years who took proton pump inhibitors long-term showed an increased risk for developing pneumonia, according to new research published in the Journal of the American Geriatrics Society.

“This study shows that there was a higher rate of pneumonia in older people who received PPIs over a two-year period,” David Melzer, MBBCh, PhD, professor of epidemiology and public health at the University of Exeter Medical School in the U.K said in a press release. “Caution is needed in interpreting the findings as our study is based on analyzing data from medical records, so other factors may be involved. However, our study adds to growing evidence that PPIs are not quite as safe as previously thought, although they are still a very useful class of medication for certain groups of patients.”

To evaluate for a connection between long-term PPI use and the incidence of pneumonia among older adults in the primary care setting, Melzer and colleagues reviewed the electronic medical records of 75,050 patients aged older than 60 years who took PPIs for at least a year and compared them with an equal number of controls matched by age and sex.

After adjusting for pneumonia incidence before initiation of treatment, they found a statistical association between long-term PPI use and incident pneumonia during the second year of treatment (prior event rate ratio (PERR)-adjusted HR = 1.82; 95% CI, 1.27-2.54). They saw similar results across subgroups based on age and comorbidity, and in alternative analysis models.

“Pneumonia risk is greater with long-term PPI therapy in older adults in primary care, independent of excess pneumonia rates immediately before first PPI receipt,” Meltzer and colleagues concluded. “In our cohort, the excess risk was statistically similar across age and comorbidity groups, but more work is needed to identify individuals at highest risk.” – by Adam Leitenberger

Disclosures: One of the authors reports he is a former employee of Pfizer and is currently employed by Alfasigma.