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Drug Exposure and Risk of Microscopic Colitis: A Systematic Review and Meta-Analysis
Shao-Wen Zhang1, Ru-Hu Xu1, Dan Chen1
1Department of Chinese Internal Medicine, Taizhou First People's Hospital, Taizhou, China.
Background And Objectives:
Microscopic colitis (MC) is a chronic inflammatory bowel disease characterized by watery diarrhoea and a normal radiological and endoscopic appearance. Concern regarding a potential association between drug exposure and MC has recently emerged. We sought to systematically review and summarize the evidence for the potential association.
Methods:
A systematic review and meta-analysis were performed to evaluate the incidence of MC associated with exposure to drug. The PubMed and Embase databases were searched to identify potential studies for inclusion.
Results:
Twelve case-control studies were included in the meta-analysis. The results showed exposure to NSAID (OR, 1.64; 95% CI: 1.14-2.37; p < 0.001), PPI (OR, 2.36; 95% CI: 1.59-3.52; p < 0.001), SSRI (OR, 2.16; 95% CI: 1.5-3.13; p < 0.001), or aspirin (OR, 2.84; 95% CI: 1.4-5.76; p < 0.001) was related to the incidence of MC; however, such relationships in PPI and SSRI may be modulated by the selection of controls. Furthermore, we did not found a positive association with other drug exposure and MC.
Conclusion:
This meta-analysis indicated that NSAID, PPI, SSRI, or aspirin consumption may increase the risk for MC. Further studies exploring drug-induced microscopic colitis should include control groups with diarrhoea and not only healthy controls.
Insights
Certain medications like NSAIDs, PPIs, SSRIs, and aspirin may increase the risk of microscopic colitis (MC), a chronic diarrheal condition. Further research is needed to confirm these drug-induced associations.
Area of Science:
- Gastroenterology
- Pharmacology
- Epidemiology
Background:
- Microscopic colitis (MC) is a chronic inflammatory bowel disease causing watery diarrhea with normal endoscopic findings.
- Emerging concerns link drug exposure to the development of MC.
- This study systematically reviews the evidence for drug-associated MC.
Approach:
- A systematic review and meta-analysis were conducted.
- PubMed and Embase databases were searched for relevant case-control studies.
- Twelve studies were included in the meta-analysis.
Key Points:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), and aspirin were associated with an increased incidence of MC.
- The association with PPIs and SSRIs may be influenced by the control groups selected.
- No significant association was found between MC and other drug exposures.
Conclusions:
- Consumption of NSAIDs, PPIs, SSRIs, or aspirin may elevate the risk of developing microscopic colitis.
- Future research on drug-induced MC should consider control groups with diarrhea, not solely healthy individuals.
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