Use and Incidence of Adverse Effects of Proton Pump Inhibitors in Patients with Cystic Fibrosis.
Pharmacotherapy. 2018 May 25. Epub 2018 May 25. PMID: 29800488
Bradley E McCrory
PURPOSE: The objective of this study was to evaluate the incidence of adverse effects associated with chronic proton pump inhibitor (PPI) use as well as the dosing, indication, and duration of use of PPIs in the cystic fibrosis population at a pediatric academic medical center.
METHODS: Study design was a retrospective chart review evaluating patients with cystic fibrosis who were prescribed a PPI for at least 6 months (PPI group) or patients with cystic fibrosis who had never been prescribed a PPI (control group) during the time period from June 1, 2014 to May 31, 2015.
RESULTS: There were 126 patients in the PPI group and 49 patients in the control group. Forty-four patients (34.9%) had an indication for both gastroesophageal reflux and enzyme enhancement, with an average PPI daily dose of 1 mg/kg/day. Twenty-one patients (16.7%) in the PPI group had an incidence of hypomagnesemia compared to one patient (2%) in the control group (p=0.097). Seventy-five patients (59.6%) receiving chronic PPI therapy had at least one pulmonary exacerbation compared to 12 patients (24.5%) in the control group (p<0.001). There was no significant difference in the incidence of hypocalcemia, low bone mineral density, or positive Clostridium difficile toxin between the two groups.
CONCLUSION: The PPI group had a higher risk of pulmonary exacerbation compared to the control group. Further studies are needed to assess adverse effects associated with chronic PPI use in patients with cystic fibrosis. This article is protected by copyright. All rights reserved.