PPIs and Obstructive Airway Disease Exacerbations

Data have suggested that proton pump inhibitor (PPI) use might be associated with exacerbations of chronic obstructive airway diseases (Figure 1); one proposed mechanism is PPI-related changes in the gut microbiome and translocation of potentially pathogenic bacteria to the lung. Evidence for the association has been inconsistent, however.

In this study, researchers used Belgian claims data to identify over 900,000 patients with chronic obstructive airway diseases, ≈45% of whom received prescriptions for PPIs over a 5-year period. Patients taking PPIs were older, with more comorbidities and prior exacerbations of lung disease; the researchers adjusted for these and other covariates to examine the risk for exacerbations associated with…