| 제목 | Use of proton pump inhibitors and the risk of cholangitis: a nationwide cohort study. | ||
|---|---|---|---|
| 작성자 | 관리자 | 등록일 | 2019-12-13 |
내용
Aliment Pharmacol Ther. 2019 Oct;50(7):760-768. doi: 10.1111/apt.15466. Epub 2019 Aug 25.
Use of proton pump inhibitors and the risk of cholangitis: a nationwide cohort study.
Min YW1, Kang D2,3, Shin JY4, Kang M3, Park JK1, Lee KH1, Lee JK1, Lee KT1, Rhee PL1, Kim JJ1, Guallar E3,5, Cho J2,3,5, Lee H1.
Author information
- 1
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- 2
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
- 4
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
- 5
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Abstract
BACKGROUND:
Proton pump inhibitor (PPI) use may alter the gut microbiome and increase the risk of cholangitis. However, the association of PPI use with the risk of incident cholangitis has not been evaluated.
AIM:
To evaluate whether PPI use was associated with a higher risk of cholangitis.
METHODS:
This cohort study included a nationwide representative sample of the Korean general population followed up for 10 years (1 January 2003 to 31 December 2013). PPI use was identified from treatment claims and considered as a time-varying variable. Incident cholangitis was identified from hospitalisation and out-patient visit claims.
RESULTS:
During 4 212 003 person-years of follow-up, 58,863 participants had at least one PPI prescription and 1 834 participants developed cholangitis. The age-, sex-, residential area- and income-adjusted hazard ratio (HR) for incident cholangitis comparing PPI use with non-use was 6.06 (95% CI, 4.64-7.91). The association was essentially unchanged in fully adjusted models (HR 5.75; 95% CI, 4.39-7.54). The risk was highest during PPI treatment and decreased gradually after PPI discontinuation (Ptrend <.001).
CONCLUSIONS:
In this large cohort, PPI use was associated with an increased risk of cholangitis. Physicians prescribing PPIs should consider cholangitis as a potential complication of PPI use.
