GERD Associated With Long-Term Risk of Pneumonia
Clinicians should be aware of increased risk of pneumonia when prescribing proton pump inhibitors to younger GERD patients.
Gastroesophageal reflux disease (GERD) is associated with long-term risk of pneumonia, particularly in the younger population and in patients who have been treated with proton pump inhibitors (PPIs) for more than 4 months, according to data published in PLoS One.
Wan-Tseng Hsu, from the School of Pharmacy at National Taiwan University, and colleagues used the Taiwan National Health Insurance Research Database to identify patients who were newly diagnosed with GERD and treated with PPIs from 2004 through 2010. The study included 15,715 GERD cases and 15,715 non-GERD matched controls.
The results showed that incidence of pneumonia was higher among patients with GERD compared with the matched controls (adjusted hazard ratio [HR], 1.48) within 6 years of follow-up.
The researchers also note that GERD had the strongest association with pneumonia in patients younger than 40 years of age (adjusted HR, 2.17). GERD patients had higher pneumonia incidence regardless of income level and the presence of comorbid hypertension, diabetes, COPD, liver disease, and cerebrovascular disease.
Compared with patients who did not receive PPI treatment, the incidence of pneumonia was higher in patients with more than 4 months of PPI use (adjusted HR, 1.93) than in patients with less than 4 months of PPI use (adjusted HR, 1.33).
“Our findings implicate that clinicians should be aware of increased risk of pneumonia for prescribing PPIs to younger GERD patients, who are usually without other comorbidity, and to severer GERD cases, whose demand for duration of PPI therapy may be longer,” the researchers concluded.
Hsu WT, Lai CC, Wang YH, et al. Risk of pneumonia in patients with gastroesophageal reflux disease: a population-based cohort study [published online August 24, 2017]. PLoS One. doi:10.1371/journal.pone.0183808