Prolonged PPI Use Could Increase Respiratory Infection Risk in CF

Proton pump inhibitors (PPIs) are a class of medicine that reduce the amount of stomach acid production. They are commonly known for their use in acid-related disorders, such as gastroesophageal reflux disease (GERD). Studies suggest that up to 20% of infants and over 50% of those with cystic fibrosis (CF) experience GERD, and up to 80% have exocrine pancreatic insufficiency. 

Patients are often given pancreatic enzyme replacement therapy (PERT). PPIs may be given to those with cystic fibrosis to enhance PERT or because PERT does not work. However, shares Cystic Fibrosis News Today, a new study suggests that long-term PPI use could increase the risk of Pseudomonas aeruginosa (P. aeruginosa) infection in these patients.

Within this study, published in Digestive and Liver Disease, a research team sourced and analyzed data from 80 individuals with CF. These patients had used PPIs for at least three months over a 4-year period. An additional 80 individuals who had never used PPIs were used as a control group. The study found that:

  • 73 patients used PPIs to treat gastroesophageal reflux disease, while seven patients used PPIs as an add-on therapy. 
  • On average, patients used PPIs for 23 months (approx. 1 year and 11 months). The most commonly prescribed proton pump inhibitor was omeprazole. 
  • Those with CF who used proton pump inhibitors had a twofold-heightened risk of being infected with P. aeruginosa. Additionally, those using PPIs were more likely to be hospitalized for pulmonary exacerbations. Learn more about pulmonary exacerbations
  • P. aeruginosa infections were more common in individuals who had used PPIs over a prolonged period of time.

Ultimately, this study found that doctors should consider the use of PPIs in patients with cystic fibrosis to avoid harmful outcomes. Additionally, those with CF who do use PPIs should be monitored. 

About Cystic Fibrosis (CF)

Cystic fibrosis is a progressive inherited disorder caused by CFTR gene mutations. Normally, the CFTR gene helps regulate salt and water movement within the body. These mutations cause mucus to become thick and sticky throughout the body. This can trap bacteria and cause infections, clog airways, and even inhibit digestion. Symptoms of CF can (but do not always) include:

  • Recurrent sinusitis and nasal polyps
  • Shortness of breath 
  • Persistent coughing or wheezing that may produce phlegm
  • Infertility (in males)
  • Constipation
  • Exercise intolerance 
  • Frequent lung infections
  • Salty-tasting skin
  • Meconium ileus (in infants)
  • Poor weight gain / failure to thrive (in infants)
  • Finger and toe clubbing
Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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