Robyn Jordan1, Sarah Shannahan2, Suzanne K Lewis3, Suneeta Krishnareddy3, Daniel A Leffler2, Peter H R Green3, Benjamin Lebwohl4. 1. Icahn School of Medicine at Mount Sinai, United States. 2. Celiac Center, Beth Israel Deaconess Medical Center, United States. 3. Celiac Disease Center, Department of Medicine, Columbia University Medical Center, United States. 4. Celiac Disease Center, Department of Medicine, Columbia University Medical Center, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, United States. Electronic address: BL114@columbia.edu.
Abstract
INTRODUCTION: The prevalence of celiac disease (CD) in the US has increased in past decades, as has use of proton pump inhibitors (PPIs), histamine-2-receptor antagonists (H2RAs), aspirin (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to measure the association between medication use and distribution of villous flattening (VF) among newly diagnosed CD patients. METHODS: We performed a cross-sectional study of adult patients with newly-diagnosed CD at two institutions. We collected data on regular use of these medications, clinical presentation, CD serologic status, and distribution of VF. We compared current ASA/NSAID users to non-users, and current PPI/H2RA users to non-users, with regard to these clinical characteristics. RESULTS: Of 148 patients with newly-diagnosed CD, current users of ASA/NSAIDs were older than non-users (47 vs 39 years, p=0.003) and users of PPI/H2RAs were older than non-users (48 vs 39 years, p=0.004). PPI/H2RA users comprised 12% of seropositive patients, compared to 55% of seronegative patients (p<0.01). Patient gender and distribution of villous flattening in the bulb and distal duodenum did not differ by PPI/H2RA or ASA/NSAID use. CONCLUSIONS: PPI/H2RA use was associated with seronegative CD. Given the effect of these medications on gastric milieu, the impact of these drugs on presentation and course of CD deserves further investigation.
INTRODUCTION: The prevalence of celiac disease (CD) in the US has increased in past decades, as has use of proton pump inhibitors (PPIs), histamine-2-receptor antagonists (H2RAs), aspirin (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to measure the association between medication use and distribution of villous flattening (VF) among newly diagnosed CD patients. METHODS: We performed a cross-sectional study of adult patients with newly-diagnosed CD at two institutions. We collected data on regular use of these medications, clinical presentation, CD serologic status, and distribution of VF. We compared current ASA/NSAID users to non-users, and current PPI/H2RA users to non-users, with regard to these clinical characteristics. RESULTS: Of 148 patients with newly-diagnosed CD, current users of ASA/NSAIDs were older than non-users (47 vs 39 years, p=0.003) and users of PPI/H2RAs were older than non-users (48 vs 39 years, p=0.004). PPI/H2RA users comprised 12% of seropositive patients, compared to 55% of seronegative patients (p<0.01). Patient gender and distribution of villous flattening in the bulb and distal duodenum did not differ by PPI/H2RA or ASA/NSAID use. CONCLUSIONS: PPI/H2RA use was associated with seronegative CD. Given the effect of these medications on gastric milieu, the impact of these drugs on presentation and course of CD deserves further investigation.
Authors: J M Mullin; M C Valenzano; M Whitby; D Lurie; J D Schmidt; V Jain; O Tully; K Kearney; D Lazowick; G Mercogliano; J J Thornton Journal: Aliment Pharmacol Ther Date: 2008-08-04 Impact factor: 8.171
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