Featured Research

from universities, journals, and other organizations

Association between common heartburn drugs and risk of pneumonia questioned

Date:
October 1, 2012
Source:
Massachusetts General Hospital
Summary:
Previous studies associating the use of proton pump inhibitors (PPI) -- which include popular anti-heartburn medications like Prilosec and Nexium -- with an increased incidence of pneumonia may not have found a true cause-and-effect relationship. A new study outlines a strategy for determining when the results of such observational studies may have been distorted by unmeasured factors and then finds that may be the case with the association between PPIs and pneumonia risk.

Previous studies that have associated the use of proton pump inhibitors (PPI) -- which include popular anti-heartburn medications like Prilosec and Nexium -- with an increased incidence of pneumonia may not have found a true cause-and-effect relationship. A study that has been released online by the Journal of General Internal Medicine outlines a strategy for determining when the results of such observational studies may have been distorted by unmeasured factors and then finds that may be the case with the association between PPIs and pneumonia risk.

"Our study is the first to show that use of PPIs most likely does not lead to higher rates of pneumonia or other health problems identified in observational studies," says Anupam Jena, MD, PhD, of the Massachusetts General Hospital (MGH) Department of Medicine, corresponding author of the article. "In fact, the associations observed in prior studies appear to reflect patient or health provider characteristics -- such as patients' overall health and likelihood to seek health care services -- not adequately accounted for in those studies. Understanding whether PPI use causes higher rates of other health problems is important, given the pervasive use of these medications."

Although observational studies -- which examine whether factors ranging from personal behavior to the use of particular medications occur more frequently in people with certain health problems -- can identify possible connections, they cannot prove that the examined factor actually caused the health problem. In the case of studies finding that patients taking PPIs were more likely to be diagnosed with pneumonia, the fact that there was a plausible mechanism for the association -- reduced production of stomach acid could allow increased growth of ingested bacteria -- has led that finding to be widely accepted. Jena notes that many physicians have urged a reduction in PPI prescriptions and the FDA has issued warnings based on associations between PPIs and infectious diarrhea found in other observational studies.

To test the validity of the association between PPI use and the risk of pneumonia, Jena and his colleagues used a strategy called 'falsification,' which other researchers have suggested as a way to test observational associations. Analyzing data reflecting 11 years of insurance claims from almost 54,500 adult beneficiaries of six employer-based health plans, they compared PPI users with non-users in terms of whether they also had received diagnosis or treatment for several health problems -- including osteoarthritis, chest pain, urinary tract infections and skin infections -- for which no plausible mechanism could explain an increased risk caused by PPIs.

The results showed that patients taking PPIs were more likely than nonusers to have osteoarthritis, chest pain, urinary tract infections -- along with pneumonia -- and also to have been diagnosed or treated for health problems such as cancer, diabetes and stroke. Even during time periods when they did not have PPI prescriptions filled, PPI users had a greater likelihood of having those or other health problems that could not plausibly be caused by taking those drugs.

"Several unmeasured factors, including physicians' likelihood of diagnosing a condition or prescribing any medication, can confound associations like the one between PPIs and pneumonia," explains Jena, who is also an assistant professor of Health Care Policy at Harvard Medical School. "The classic example of the limitations of observational studies was the association between hormone replacement therapy and reduced heart disease in postmenopausal women, which was disproved by randomized, controlled studies. Falsification testing can help assess whether the associations found in observational studies are real, and I think we should consider whether they should be required to validate all observational studies."

Co-authors of the JGIM study are Eric Sun, MD, PhD, Stanford University Hospitals, and Dana Goldman, PhD, Schaeffer Center for Health Policy and Economics, University of Southern California. The study was supported by a grant from the National Institute on Aging, and no industry funding was involved.


Story Source:

The above story is based on materials provided by Massachusetts General Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Anupam B. Jena, Eric Sun, Dana P. Goldman. Confounding in the Association of Proton Pump Inhibitor Use With Risk of Community-Acquired Pneumonia. Journal of General Internal Medicine, 2012; DOI: 10.1007/s11606-012-2211-5

Cite This Page:

Massachusetts General Hospital. "Association between common heartburn drugs and risk of pneumonia questioned." ScienceDaily. ScienceDaily, 1 October 2012. <www.sciencedaily.com/releases/2012/10/121001125237.htm>.
Massachusetts General Hospital. (2012, October 1). Association between common heartburn drugs and risk of pneumonia questioned. ScienceDaily. Retrieved April 24, 2014 from www.sciencedaily.com/releases/2012/10/121001125237.htm
Massachusetts General Hospital. "Association between common heartburn drugs and risk of pneumonia questioned." ScienceDaily. www.sciencedaily.com/releases/2012/10/121001125237.htm (accessed April 24, 2014).

Share This



More Health & Medicine News

Thursday, April 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Fungus Killing Bats, Spreading in US

Deadly Fungus Killing Bats, Spreading in US

AP (Apr. 24, 2014) A disease that has killed more than six million cave-dwelling bats in the United States is on the move and wildlife biologists are worried. White Nose Syndrome, discovered in New York in 2006, has now spread to 25 states. (April 24) Video provided by AP
Powered by NewsLook.com
Companies Ramp Up Wellness to Lower Health Costs

Companies Ramp Up Wellness to Lower Health Costs

AP (Apr. 24, 2014) That little voice telling you to exercise, get in shape and get healthy is probably coming from your boss. More companies are beefing up wellness programs to try and cut down their health care costs. (April 24) Video provided by AP
Powered by NewsLook.com
Blood From World's Oldest Woman Suggests Life Limit

Blood From World's Oldest Woman Suggests Life Limit

Newsy (Apr. 24, 2014) Scientists say for the extremely elderly, their stem cells might reach a state of exhaustion. This could limit one's life span. Video provided by Newsy
Powered by NewsLook.com
FDA Wants To Ban Sales Of E-Cigarettes To Minors

FDA Wants To Ban Sales Of E-Cigarettes To Minors

Newsy (Apr. 24, 2014) The Food and Drug Administration wants to crack down on the use of e-cigarettes, banning the sale of the product to minors. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins