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Heartburn Drugs Linked To Pneumonia
Heartburn Drugs Linked To Pneumonia -- Posted by Gumbo on 11-04-04 17:30
Heartburn Drugs Linked To Pneumonia
October 27, 2004
CHICAGO (AP) -- Widely used heartburn and ulcer drugs such as Nexium, Pepcid
and Prilosec can make people more susceptible to pneumonia, probably because
they reduce germ-killing stomach acid, Dutch researchers found in a study of
more than 300,000 patients.
The highest risks occurred with more powerful acid-fighting drugs called
proton pump inhibitors, which are sold in the United States under such brand
names as Nexium, Prevacid and Prilosec. Over nearly three years, users of
these drugs faced almost double the risk of developing pneumonia compared
with former users.
Users of another class of acid-fighting drugs that includes cimetidine and
famotidine -- sold in the United States as Tagamet and Pepcid -- also faced
an elevated risk.
The study was led by researcher Robert J.F. Laheij at University Medical
Center St. Radboud in Nijmegen, Netherlands, and appears in Wednesday's
Journal of the American Medical Association.
The acid in normal stomach fluids generally kills harmful bacteria;
suppressing it with drugs to treat heartburn and ulcers may make the body
more hospitable to such germs, which may then infect the lungs and cause
pneumonia, the researchers said.
These heavily promoted medicines are among the most widely prescribed drugs
worldwide, with almost $13 billion in sales in 1998 alone, according to a
JAMA editorial. Millions of Americans take these drugs, which are heavily
advertised in "ask your doctor about ..." TV commercials.
Older patients and those with asthma and other chronic lung ailments are
especially vulnerable to pneumonia. In light of the latest findings, the
researchers said such patients should use these medicines "only when
necessary and with the lowest possible dose."
Among the 364,683 patients whose medical records were studied, 5,551 cases
of pneumonia were diagnosed -- 185 of them in people taking acid-suppressing
drugs.
The researchers said their findings translate to about one case of pneumonia
for 226 patients treated with the more potent acid-fighting drugs and one
case per 508 patients treated with the other drugs.
Users of the more potent drugs were 89 percent more likely than former users
to develop pneumonia. Patients using the less potent drugs were 63 percent
more likely to develop pneumonia than former users of those drugs.
Nevertheless, the findings are reassuring because the apparent increase in
the risk of pneumonia was small, said Dr. James Gregor of the University of
Western Ontario.
Moreover, the study does not actually prove that the drugs cause pneumonia,
said Gregor, who wrote the JAMA editorial and was not involved in the
research. Regardless of which medication a patient is taking, heartburn, or
acid reflux disease, can cause a person to accidentally inhale regurgitated
stomach acid, increasing the risk of pneumonia, he said.
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