Anti-Allergy Drug Need Associated With Use of Gastric Suppression Agents

This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology annual meeting, taking place in San Francisco, California. Our staff will report on medical research related to asthma, allergy, and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI 2019.

SAN FRANCISCO — People who take gastric acid suppression agents have a high risk of requiring subsequent anti-allergy drugs, according to research presented at the 2019 Annual Meeting of the American College of Allergy, Asthma & Immunology (AAAAI) held February 22-25, in San Francisco.

Researchers sought to evaluate the frequency of anti-allergy drug prescription use after gastric acid inhibitors in patients residing in Austria. “Anti-ulcer drugs, such as proton pump inhibitors (PPI), are widely prescribed and used in developed countries worldwide,” the investigators wrote. “Recently, concerns about the promotion of allergic sensitizations following gastric pH modulation have been raised in mechanistic and observational studies.”

The cross-sectional study used age- and sex-controlled data from Austrian health insurance claims recorded between 2009 and 2013. A total of 8.2 million individuals were included, representing 97% of the country’s population. The researchers evaluated patient data for prescriptions of gastric acid inhibitors (eg, PPI, H2-receptor antagonists, sucralfate, prostaglandin E2) as well as for anti-allergy medications (eg, antihistamines, desensitization therapy). A Cox regression analysis in a regional subgroup used lipid-modifying and antihypertensive substances, commonly prescribed drugs, as controls.

The overall Austrian data and the regional data had rate ratios (RR) of 1.96 (95% CI, 1.95-1.97) and 3.07 (95% CI, 2.89-3.27), respectively, for anti-allergy drug prescriptions following gastric acid inhibitors. The RRs were more common in women (P <.001). The age- and sex-adjusted hazard ratio (2.05; 95% CI, 1.91-2.19) was elevated independent of prescribed gastric acid-inhibiting agents. Increases in RRs were observed in people age <20 years (RR, 1.47; 95% CI, 1.45-1.49) and people age >60 years (5.20; 95% CI, 5.15-5.25).

The applicability of these findings to other populations may be limited because of the use of an Austrian database.

“Prescription of anti-ulcer drugs should be restricted to cases with clear indication and adequate diagnosis to minimize the risk for allergic comorbidities,” the researchers concluded.

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Reference

Jensen-Jarolim E, Kundi M, Untersmayr E, Pali-Schoell I, Reichardt B, Jordakieva G. Gastric pH modulation increases risk for subsequent prescription of anti-allergy medication: evidence from a nationwide cross-sectional study. Presented at: the Annual Meeting of the American Academy of Allergy, Asthma & Immunology; February 22-25, 2019; San Francisco, CA. Abstract 846.