Link: 22 minute video —COVID-19 and the GI Tract -What We Know Right Now
A recent study (C Ma et al. Gastroenterol 2020; 158: 780-82) used cross-sectional data from the National Ambulatory Medical Care Survey (NAMCS) (2006-2015) with a total 7,872,115,883 weighted observations. They used this data to evaluate medication exposures and outcomes.
- There was no association between PPI use and dementia, pneumonia, or intestinal infections. There was a trend towards intestinal infections (AOR 1.48, CI 0.80-2.71) but this did not reach statistical significance. “Sensitivity analysis showed an association between PPI use and C difficile.”
- There was an association with chronic kidney disease (CKD) (AOR 1.26); however, this was seen with a multitude of drug classes including statins, calcium channel blockers, and beta-blockers.
- This study notes that a recent large randomized controlled trial found no statistically significant differences between those receiving PPIs and those receiving placebo except for intestinal infections.
- With regard to CKD, “it is extremely unlikely that all of these medications increase the risk of CKD, and therefore, it is likely that these findings are due to residual confounding.”
My take: With the exception of C difficile/intestinal infections, this study provides further evidence of the safety of PPIs and a lack of association between these medications and purported PPI-related adverse events. That said, it is still a good idea to limit use for appropriate indications.
Related blog posts:
- PPIs: Good News on Safety Large randomized double-blind study of pantoprazole: “we found that pantoprazole is not associated with any adverse event when used for 3 years, with the possible exception of an increased risk of enteric infections.”
- PPIs: Good News on Safety (Part 2, 2019)
- Favorable “Break”through Data for PPIs and Bone Density
- Which PPIs are most potent?
- PPIs: Dissecting the Evidence
- The Prosecution Rests…PPIs on Trial
- No Effect of Proton Pump Inhibitors and Irritability on Crying in Infants
- Two for the PPI Team
- Proton Pump Inhibitors Webinar | gutsandgrowth
Also, IOIBD recommendations for IBD patients and COVID-19 have been published.
Here is link as well:
IOIBD (International Organization for the Study of Inflammatory Bowel Disease) Recommendations (#76) for IBD Patients with Regard to COVID-19:
Full link: IOIBD Update on COVID19 for Patients with Crohn’s Disease and Ulcerative Colitis (3/26/20)