Bradley E McCrory1, Heidi N Harper2, Gary L McPhail3. 1. Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 2. Division of Home Care Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Abstract
PURPOSE: To evaluate the incidence of adverse effects associated with chronic proton pump inhibitor (PPI) use as well as the dosing, indication, and duration of use of PPIs in the cystic fibrosis (CF) population at a pediatric academic medical center. METHODS: Study design was a retrospective chart review evaluating patients with CF who were prescribed a PPI for at least 6 months (PPI group) or patients with CF who had never been prescribed a PPI (control group) from June 1, 2014, to May 31, 2015. RESULTS: The study enrolled 126 patients in the PPI group and 49 patients in the control group. Forty-four patients (34.9%) had an indication for both gastroesophageal reflux and enzyme enhancement, with an average PPI daily dose of 1 mg/kg/day. Twenty-one patients (16.7%) in the PPI group had an incidence of hypomagnesemia compared with one patient (2%) in the control group (p=0.097). Overall, 75 patients (59.6%) receiving chronic PPI therapy had at least one pulmonary exacerbation compared with 12 patients (24.5%) in the control group (p<0.001). No significant difference was noted in the incidence of hypocalcemia, low bone mineral density, or positive Clostridium difficile toxin between the two groups. CONCLUSION: The PPI group had a higher risk of pulmonary exacerbation compared with the control group. Further studies are needed to assess adverse effects associated with chronic PPI use in patients with CF.
PURPOSE: To evaluate the incidence of adverse effects associated with chronic proton pump inhibitor (PPI) use as well as the dosing, indication, and duration of use of PPIs in the cystic fibrosis (CF) population at a pediatric academic medical center. METHODS: Study design was a retrospective chart review evaluating patients with CF who were prescribed a PPI for at least 6 months (PPI group) or patients with CF who had never been prescribed a PPI (control group) from June 1, 2014, to May 31, 2015. RESULTS: The study enrolled 126 patients in the PPI group and 49 patients in the control group. Forty-four patients (34.9%) had an indication for both gastroesophageal reflux and enzyme enhancement, with an average PPI daily dose of 1 mg/kg/day. Twenty-one patients (16.7%) in the PPI group had an incidence of hypomagnesemia compared with one patient (2%) in the control group (p=0.097). Overall, 75 patients (59.6%) receiving chronic PPI therapy had at least one pulmonary exacerbation compared with 12 patients (24.5%) in the control group (p<0.001). No significant difference was noted in the incidence of hypocalcemia, low bone mineral density, or positive Clostridium difficile toxin between the two groups. CONCLUSION: The PPI group had a higher risk of pulmonary exacerbation compared with the control group. Further studies are needed to assess adverse effects associated with chronic PPI use in patients with CF.
Authors: Meghana Sathe; Rong Huang; Sonya Heltshe; Alexander Eng; Elhanan Borenstein; Samuel I Miller; Lucas Hoffman; Daniel Gelfond; Daniel H Leung; Drucy Borowitz; Bonnie Ramsey; A Jay Freeman Journal: J Pediatr Gastroenterol Nutr Date: 2021-09-01 Impact factor: 3.288