Proton pump inhibitor use, particularly Prevacid, was associated with microscopic colitis, according to research published in Alimentary Pharmacology & Therapeutics.
Ole K. Bonderup, MD, of University Research Clinic for Innovative Patient Pathways at Aarhus University in Denmark, and colleagues wrote that studies have linked PPI use to microscopic colitis before, but they did not discuss the topic in-depth.
“It is unclear whether the association between PPI and microscopic colitis applies equally to lymphocytic colitis and collagenous colitis,” they wrote. “Some studies have suggested a specific risk with lansoprazole [Prevacid, GlaxoSmithKline]. However, this finding is predominantly based on case reports or smallscale casecontrol studies.”
Additionally, they said it is unknown how the pattern of PPI use plays into the development of microscopic colitis.
Using national Danish health registries, Bonderup and colleagues analyzed data from 10,652 patients with first-time diagnosis of microscopic colitis between 2004 and 2013. They obtained PPI use information from the Danish Prescription Register and identified 6,254 patients with collagenous colitis (59%) and 4,398 patients with lymphocytic colitis (41%).
After adjusting for potential confounders, Bonderup and colleagues found “strong” associations between current PPI use and both collagenous colitis (adjusted OR = 6.98; 95% CI, 6.45–7.55) and lymphocytic colitis (aOR = 3.95; 95% CI, 3.6–4.33).
While they found this association with all PPIs, they wrote that it was strongest with the current use of lansoprazole for both collagenous colitis (aOR = 15.74; 95% CI, 14.12–17.55) and lymphocytic colitis (aOR = 6.87; 95% CI, 6–7.86).
Investigators found the link between PPIs and microscopic colitis was stronger for current use compared with past use but found no clear dose-response pattern.
“The potential roles of PPI exposure in the development of collagenous colitis and development of lymphocytic colitis should be further explored,” the researchers wrote. “There is currently insufficient evidence to recommend specific strategies for PPI use in patients with microscopic colitis. As always, an inappropriately prescribed PPI should be discontinued.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.