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Roman

"Acid-Suppressing Drugs May Raise Pneumonia Risk", Reuters, October
26, 2004,
Link: http://www.reuters.co.uk/newsArticle.jhtml;jsessionid=NDTULR1CZCZ34CRBAELCFEY?ty
pe=healthNews&storyI

People who take medication to reduce stomach acid seem to be at
increased risk of developing pneumonia, the results of a population-
based study suggest.

The findings apply to both proton pump inhibitors (PPIs) such as
Nexium or Prevacid, for example, and to H2-receptor antagonists, which
include popular products such as Pepcid and Zantac

While the effectiveness of acid-suppressive drugs in the treatment of
heartburn and reflux disease is "excellent," these agents seem to have
some "significant drawbacks," investigators write in this week's
Journal of the American Medical Association.

In the study, Dr. Robert J. F. Laheij from the University Medical
Center St. Radboud in Nijmegen, the Netherlands and colleagues used
information in a national primary care database to analyze pneumonia
rates in individuals who did or did not use acid-suppressing drugs.
The analysis included 364,683 Dutch subjects and 5551 first
occurrences of pneumonia.

The incidence rate of pneumonia in acid-suppressive drug users was
2.45 per 100 persons per year, compared with 0.6 among people who
didn't take these types of drugs.

After factoring various adjustments, the team estimated that the risk
of pneumonia was 89 percent higher for current users of PPIs and 63
percent higher for current users of H2-receptor antagonists, compared
with past users of these agents.

"The increased risk for pneumonia is a problem for patients who are at
increased risk for infection, especially because community-acquired
pneumonia is potentially dangerous," Laheij and colleagues note.

The results of this study are "noteworthy," writes Dr. James C. Gregor
from the University of Western Ontario in London, Ontario, Canada, in
an editorial.

"If acid suppression causes some cases of pneumonia, it is reassuring
that the risk is relatively small and that the complication in most
cases is usually amenable to therapy," he contends.

Nonetheless, Gregor reminds doctors that "concerns for patient safety
should guide initial prescribing and perhaps more importantly, chronic
use of even the most apparently benign drugs."

SOURCE: Journal of the American Medical Association, October 27, 2004.