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Regular use of proton pump inhibitor and risk of rheumatoid arthritis in women: a prospective cohort study.


ABSTRACT:

Background

Proton pump inhibitors (PPIs) have a significant impact on the gut microbiome, which in turn, might increase the risk of rheumatoid arthritis (RA).

Aim

To evaluate regular use of PPIs and risk of RA.

Methods

This is a prospective analysis of the US nurses who reported PPI use data, and were free of RA from the Nurses' Health Study (NHS 2002-2014) and NHS II (2003-2015). The exposure was regular use of PPI in the past 2 years, which was repeatedly evaluated in biennial surveys. RA was confirmed by the 1987 or 2010 American College of Rheumatology criteria. We estimated the hazard ratios (HRs) and confidence interval (CIs) with time-dependent Cox regression adjusting for potential confounders.

Results

We documented 421 cases of RA over 1 753 879 person-years of follow-up. Regular PPI users had a 44% higher risk of RA as compared with non-regular users (adjusted HR = 1.44; 95%CI, 1.10-1.89). The risk of RA increased with the total duration of PPI use (P-trend = 0.008). Compared with non-regular users, the adjusted HRs were 1.22 (95%CI, 0.93-1.62) for women with >0 to 4 years' use and 1.73 (95% CI, 1.14 to 2.61) for >4 years' use.

Conclusions

Regular use of PPI was associated with increased risk of RA in women, with a higher risk observed in individuals with a longer duration of PPI use. Due to the observational study design, large prospective trials are still required to confirm our finding.

SUBMITTER: Yuan J 

PROVIDER: S-EPMC7406413 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Regular use of proton pump inhibitor and risk of rheumatoid arthritis in women: a prospective cohort study.

Yuan Jinqiu J   Zhang Changhua C   Sparks Jeffrey A JA   Malspeis Susan S   Tsoi Kelvin Kam-Fai KK   Kim Jean H JH   Fisher Benjamin A BA   Gao Fang F   Sumerlin Tim T   Liu Yan Y   Liu Yuxing Y   Pan Yihang Y   He Yulong Y   Sung Joseph J Y JJY  

Alimentary pharmacology & therapeutics 20200629 3


<h4>Background</h4>Proton pump inhibitors (PPIs) have a significant impact on the gut microbiome, which in turn, might increase the risk of rheumatoid arthritis (RA).<h4>Aim</h4>To evaluate regular use of PPIs and risk of RA.<h4>Methods</h4>This is a prospective analysis of the US nurses who reported PPI use data, and were free of RA from the Nurses' Health Study (NHS 2002-2014) and NHS II (2003-2015). The exposure was regular use of PPI in the past 2 years, which was repeatedly evaluated in bie  ...[more]

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