Allergy added to the list of “side effects” of a popular drug

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Patients who use drugs to restore the acidity of gastric juice are at greater risk of developing allergies.

On the one hand, doctors usually prescribe proton pump inhibitors (PPIs) for safety reasons, but on the other hand, patients often abuse them because they are available on the pharmaceutical market.

Recent studies have shown that the use of drugs that reduce stomach acid can cause allergies. The researchers found that patients in the general population who were prescribed such drugs were almost twice as likely to receive prescriptions for anti-allergy drugs as those who did not take drugs to reduce acidity. The researchers included any prescription for drugs that inhibit acidity (for example, PPIs, sucralfate, H2-receptor antagonists or prostaglandin E2) and/or any prescription for an anti-allergy drug (for example, antihistamines or allergen-specific immunotherapy). Allergies mainly occur against the background of a violation of the gastrointestinal tract, so some products must be excluded to avoid this problem.Overall, the ratio of prescriptions increased for all classes of gastric acid inhibitors analyzed, except for PGE2, which was prescribed too infrequently for the data to be conclusive.

However, the ratio was higher among women than men (2.10 vs. 1.70; P < 0.001). An age-related trend was also observed among all patients: incidence ratios increased from 1.47 (95% CI, 1.45-1.49) in those <20 years of age to 5.20 (95% CI, 5.15-5.25) in those >60 years of age.

As few as six doses of gastric acid inhibitors per year were associated with a higher likelihood of being prescribed anti-allergy medications. In addition, when patients were grouped into quartiles based on daily doses per year of gastric acid inhibitors, the analysis showed that cumulative exposure to these inhibitors also increased the risk of taking anti-allergy medications. For example, for patients receiving up to 20 daily doses per year (first quartile), the hazard ratio was 1.28 (95% CI, 1.18-1.39). This ratio increased to 2.67 (95% CI, 2.47-2.88) for those receiving 68 to 213 daily doses per year (third quartile). The effect appeared to plateau at this level, with a hazard ratio of 2.57 (95% CI, 2.38-2.78) for patients receiving more than 213 daily doses per year (fourth quartile). Because the association with antiallergic drug use was found across most classes of gastric acid inhibitors analyzed in the study, the authors concluded that the underlying mechanism may be related to gastric pH regulation rather than to the specific mode of action of the individual drugs. These findings add to the growing body of evidence that the use of gastric acid inhibitors is associated with allergy risk. “Our results support the epidemiological association between gastric acid suppression and the development of allergic symptoms consistent with previous mechanistic animal studies and observational human studies,” conclude Jordakieva and colleagues.