PPIs linked with increased risk for RA in women
Regular use of proton pump inhibitors was associated with increased risk for rheumatoid arthritis in women, according to research published in Alimentary Pharmacology & Therapeutics.
Yihang Pan, of the Precision Medicine Center at The Seventh Affiliated Hospital in China, and colleagues wrote that the gut microbiota has an impact on the function of the immune system, which could have an effect on the pathogenesis of RA.
“Long-term use of PPIs may be associated with RA through intestinal dysbiosis,” they wrote. “However, epidemiological evidence remains unclear.”
Researchers analyzed prospective data collected from nurses in the United States who reported PPI use data and were free of RA from the Nurses’ Health Study (2002-2014) and NHS II (2003-2015). They defined exposure as regular use of PPI in the past years.
Investigators identified 421 cases of RA over 1,753,879 person-years of follow-up. Regular users of PPI had a 44% higher risk for RA compared with individuals who reported non-regular use (adjusted HR = 1.44; 95% CI, 1.1-1.89).
Risk for RA increased with the total duration of PPI use (P for trend = .008). Compared with non-regular users, women with 4 years or less of regular use (adjusted HR = 1.22; 95% CI, 0.93-1.62) and women with greater than 4 years of regular use (aHR = 1.73; 95% CI, 1.14-2.61) were at higher risk for RA.
“As PPIs have been linked with other health problems, such as fractures and gastric cancer, our study once again suggested the importance of carefully evaluating the need for long-term, continuous use of PPIs,” Pan and colleagues wrote. “Further research is required to confirm our findings as well as to investigate the underlying mechanisms."