Association Between Proton Pump Inhibitors and Asthma: A Population-Based Cohort Study

Area of Science:

• Gastroenterology
• Pulmonology
• Epidemiology

Background:

• The association between proton pump inhibitors (PPIs) and asthma remains controversial.
• This study investigates the link between PPI use and subsequent asthma development in individuals without a prior asthma diagnosis.

Purpose of the Study:

• To determine the association between long-term PPI use and the incidence of asthma in a non-asthma population.
• To assess the risk of new-onset asthma in patients using PPIs compared to a control group.

Main Methods:

• A nationwide, population-based retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database (1999-2013).
• 24,077 adult PPI users (for >3 months) were matched 1:1 with non-PPI controls based on propensity scores, considering age, gender, comorbidities, and other medications.
• Asthma incidence was estimated using Kaplan-Meier analysis, with differences analyzed by log-rank tests and adjusted hazard ratios (HR) calculated via multivariate Cox regression.

Main Results:

• The incidence of asthma was 1.58-fold higher in the PPI cohort (13.3 per 1,000 person-years) versus the non-PPI cohort (8.4 per 1,000 person-years).
• The adjusted HR for asthma associated with PPI use was 1.76 (95% CI, 1.64-1.88).
• Increased asthma risk was observed in patients without prior peptic ulcer disease and those not concurrently using H2RA, NSAIDs, or acetaminophen.

Conclusions:

• Long-duration PPI use is associated with an increased risk of developing asthma.
• This association holds true across various demographics, comorbidities, and concomitant medication use.