ArticleJournal of general internal medicine2013
Confounding in the association of proton pump inhibitor use with risk of community-acquired pneumonia.
Article in Journal of general internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Proton pump inhibitor use: systematic review of global trends and practices.European journal of clinical pharmacology · 2023Pooled it
- Proton pump inhibitors for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2020Pooled it
- Guideline
- Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis.PloS one · 2015Pooled it
- Pooled it
- Lansoprazole Is Associated with Worsening Asthma Control in Children with the CYP2C19 Poor Metabolizer Phenotype.Annals of the American Thoracic Society · 2015Trial
- Prenatal and/or childhood acid-suppressive medication use and risk of serious infections in children: A retrospective analysis of Taiwanese medical claims data.BMC medicine · 2026Article
- Nonvitamin K Anticoagulants: Risk of Bleeding When Interacting With Other Medications: A Cohort Study From Medicare.Clinical cardiology · 2024Observational
- Analysis of Risk Factors for Febrile Neutropenia in Patients with Small-Cell Lung Cancer Receiving Carboplatin Plus Etoposide Therapy.Oncology · 2024Article
- Proton pump inhibitor use and risk of pneumonia: a self-controlled case series study.Journal of gastroenterology · 2023Article
- Article
- Pre-existing Proton Pump Inhibitor Treatment and Short-Term Prognosis of Acute Myocardial Infarction Patients.Frontiers in cardiovascular medicine · 2022Article
- Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions.Journal of asthma and allergy · 2022Review
- Regular use of proton pump inhibitor and risk of rheumatoid arthritis in women: a prospective cohort study.Alimentary pharmacology & therapeutics · 2020Observational
- Proton Pump Inhibitors and Infection-Related Hospitalizations Among Residents of Long-Term Care Facilities: A Case-Control Study.Drugs & aging · 2019Article
- Article
- Proton pump inhibitors: Review of reported risks and controversies.Laryngoscope investigative otolaryngology · 2018Review
- Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings.Journal of the American Heart Association · 2018Article
- Correlation between proton pump inhibitors and risk of pyogenic liver abscess.European journal of clinical pharmacology · 2017Article
- Proton pump inhibitors as a risk factor for norovirus infection.Epidemiology and infection · 2017Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUse of proton pump inhibitors (PPIs) is associated with community-acquired pneumonia (CAP), an association which may be confounded by unobserved patient and prescriber characteristics.
objectiveWe assessed for confounding in the association between PPI use and CAP by using a 'falsification approach,' which estimated whether PPI use is also implausibly associated with other common medical conditions for which no known pathophysiologic link exists.
designRetrospective claims-based cohort study.
settingSix private U.S. health plans. SUBJECTS: Individuals who filled at least one prescription for a PPI (N = 26,436) and those who never did (N = 28,054) over 11 years.
interventionsMultivariate linear regression of the association between a filled prescription for a PPI and a diagnosis of CAP in each 3-month quarter. In falsification analyses, we tested for implausible associations between PPI use in each quarter and rates of osteoarthritis, chest pain, urinary tract infection (UTI), deep venous thrombosis (DVT), skin infection, and rheumatoid arthritis. Independent variables included an indicator for whether a prescription for a PPI was filled in a given quarter, and quarterly indicators for various co-morbidities, age, income, geographic location, and marital status. KEY
resultsCompared to nonusers, those ever using a PPI had higher adjusted rates of CAP in quarters in which no prescription was filled (68 vs. 61 cases per 10,000 persons, p < 0.001). Similar associations were noted for all conditions (e.g. chest pain, 336 vs. 282 cases, p < 0.001; UTI, 151 vs. 139 cases, p < 0.001). Among those ever using a PPI, quarters in which a prescription was filled were associated with higher adjusted rates of CAP (111 vs. 68 cases per 10,000, p < 0.001) and all other conditions (e.g. chest pain, 597 vs. 336 cases, p < 0.001; UTI, 186 vs. 151 cases, p < 0.001), compared to quarters in which no prescription was filled.
conclusionPPI use is associated with CAP, but also implausibly associated with common medical conditions. Observed associations between PPI use and CAP may be confounded.
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