Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study

Background: COVID-19 is a disease of the elderly as 95% of deaths related to COVID-19 occur in people over 60 years of age. Despite the urgent need for a preventive treatment there are currently no serious leads, other than the vaccination. Objective: To find a preventive treatment of COVID-19 in elderly patients. Design: Retrospective case-control study. Setting: Robertsau Geriatric Hospital of the University Hospitals of Strasbourg, France. Patients: 179 elderly patients who had been in contact with the SARS-CoV-2, of whom 89 had tested RT-PCR-positive (COVID-pos) for the virus and 90 had tested RT-PCR-negative (COVID-neg). Measurements: Treatments within 15 days prior to RT-PCR (including antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors (PPIs), paracetamol, anticoagulant, oral antidiabetics (OADs), corticosteroids, immunosuppressants), comorbidities, symptoms, laboratory values, and clinical outcome were all collected using the electronic patient record. Results: COVID-pos patients more frequently had a history of diabetes (P=.016) and alcoholism (P=.023), a lower leukocyte count (P=.014) and a higher mortality rate– 29.2% versus 14.4% – (P=.014) when compared to COVID-neg patients. Patients on PPIs were 2.3 times less likely (odds ratio [OR] = 0.4381, 95% confidence interval [CI] [0.2331, 0.8175], P=.0053) to develop COVID-19 infection, compared to those not on PPIs. No other treatment decreased or increased this risk. COVID-19 patients on antipsychotics (P=.0013) and OADs (P=.0166) were less likely to die. Limitations: retrospective study. Conclusion: PPIs treatment lowered the risk of development of COVID-19 infection, and antipsychotics and OADs decreased the risk of mortality in geriatric patients. If further studies confirm this finding, PPIs could be used preventatively in the elderly in this pandemic context. Moreover, OADS and antipsychotics should be tested in clinical trials.

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744. Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine and Influenza Vaccine Against Pneumococcal Pneumonia Among Elderly Patients Aged 65 Years and Older in the Republic of Korea: A Case–Control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.751 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S267-S267

Author(s):

Jong Hun Kim ◽

Byung Chul Chun ◽

Joon Young Song ◽

Hyo Youl Kim ◽

In-Gyu Bae ◽

...

Keyword(s):

Elderly Patients ◽

Elderly Population ◽

Case Control Study ◽

The Elderly ◽

Case Control ◽

Polysaccharide Vaccine ◽

Vaccine Effectiveness ◽

Pneumococcal Polysaccharide Vaccine ◽

The Republic ◽

Control Study

Abstract Background The national immunization program (NIP) of annual influenza vaccination to the elderly population (≥65 years of age) in the Republic of Korea (ROK) has been implemented since 1987. Recently, the 23-valent pneumococcal polysaccharide vaccine (PPV23) through the NIP has been provided to the elderly population in the ROK since May 2013. The aim of this study was to assess PPV23 and influenza vaccine (IV) effectiveness in preventing pneumococcal pneumonia (PP) among elderly patients ≥65 years of age. Methods A case–control study using a hospital-based cohort was conducted. Cases of PP including bacteremic PP and nonbacteremic PP were collected from 14 hospitals in the pneumococcal diseases surveillance program from March 2013 to October 2015. Controls matched by age and sex in the same hospital were selected. Demographic, clinical information, and vaccination histories were collected. Previous immunization was categorized into “vaccinated” if a patient had received vaccines as follows: PPV23 (4 weeks to 5 years) and IV (2 weeks to 6 months) prior to the diagnosis of PP for case patients and prior to the hospital admission for control patients. Adjusted odds ratio (OR) was calculated, controlling for underlying medical conditions. Vaccine effectiveness was defined as (1 – OR) × 100. Results During the study period, a total of 661 cases (104 bacteremic PP cases and 557 nonbacteremic PP cases) and 661 controls were enrolled for analyses. For overall patients ≥65 years of age, there was no significant vaccine effectiveness against PP. For young elderly patients with 65–74 years, IV alone (1.2%, [95% confidence interval (CI) −95.3% to 50.0%]) and PPV23 alone (21.9%, [95% CI −39.0% to 56.1%]) were not effective. However, significant vaccine effectiveness of PPV23 plus IV against PP was noted (54.4%, [95% CI 6.9–77.7%], P = 0.031). For older elderly patients ≥75 years of age, no significant vaccine effectiveness was observed. Conclusion Our study indicates that PPV23 plus IV may be effective in preventing PP among young elderly patients with 65–74 years, suggesting additive benefits of influenza plus PPV23 vaccination. Further studies are required to confirm the persistent additive protective effectiveness. Disclosures All authors: No reported disclosures.

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Association of proton pump inhibitors and concomitant drugs with risk of acute kidney injury: a nested case–control study

BMJ Open ◽

10.1136/bmjopen-2020-041543 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041543

Author(s):

Keiko Ikuta ◽

Shunsaku Nakagawa ◽

Kenji Momo ◽

Atsushi Yonezawa ◽

Kotaro Itohara ◽

...

Keyword(s):

Acute Kidney Injury ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Case Control Study ◽

Kidney Injury ◽

Case Control ◽

Renal Diseases ◽

Increased Risk ◽

Nested Case Control ◽

Control Study

ObjectivesThis study aimed to assess whether the combined use of proton pump inhibitors (PPIs) with non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics (penicillins, macrolides, cephalosporins or fluoroquinolones) was associated with an increased risk of acute kidney injury (AKI).DesignA nested case–control study.SettingA health insurance claims database constructed by the Japan Medical Data Center.ParticipantsPatients were eligible if they were prescribed a PPI, NSAID and antibiotic at least once between January 2005 and June 2017. The patients who were new PPI users and did not have any history of renal diseases before cohort entry were included (n=219 082). The mean age was 45 and 44% were women.InterventionsCurrent use of PPIs, NSAIDs, or antibiotics.Primary outcome measuresAcute kidney injury.ResultsDuring a mean follow-up of 2.4 (SD, 1.7) years, 317 cases of AKI were identified (incidence rate of 6.1/10 000 person-years). The current use of PPIs was associated with a higher risk of AKI compared with past PPI use (unadjusted OR, 4.09; 95% CI, 3.09 to 5.44). The unadjusted ORs of AKI for the current use of PPIs with NSAIDs, cephalosporins and fluoroquinolones, compared with the current use of PPIs alone, were 3.92 (95% CI, 2.40 to 6.52), 2.57 (1.43 to 4.62) and 3.08 (1.50 to 6.38), respectively. The effects of concurrent use of PPIs with NSAIDs, cephalosporins or fluoroquinolones remain significant in the adjusted model. The analyses on absolute risk of AKI confirmed the results from the nested case–control study.ConclusionsConcomitant use of NSAIDs with PPIs significantly increased the risk for AKI. Moreover, the results suggested that concomitant use of cephalosporins or fluoroquinolones with PPIs was associated with increased risk of incident AKI.

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PREVALENCE OF SMALL BOWEL INTESTINAL BACTERIAL OVERGROWTH (SIBO) IN CHRONIC PROTON PUMP INHIBITORS USERS: A PILOT CASE-CONTROL STUDY

Digestive and Liver Disease ◽

10.1016/s1590-8658(09)60372-8 ◽

2009 ◽

Vol 41 ◽

pp. S142 ◽

Cited By ~ 2

Author(s):

S. Saettone ◽

L. Broglia ◽

P. Occhipinti

Keyword(s):

Small Bowel ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Case Control Study ◽

Bacterial Overgrowth ◽

Case Control ◽

Intestinal Bacterial Overgrowth ◽

Control Study

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Incremental cost effectiveness of proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug ulcers: a pharmacoeconomic analysis linked to a case-control study

Arthritis Research & Therapy ◽

10.1186/ar2577 ◽

2008 ◽

Vol 10 (6) ◽

pp. R144 ◽

Cited By ~ 5

Author(s):

Harald E Vonkeman ◽

Louise MA Braakman-Jansen ◽

Rogier M Klok ◽

Maarten J Postma ◽

Jacobus RBJ Brouwers ◽

...

Keyword(s):

Cost Effectiveness ◽

Incremental Cost ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Case Control Study ◽

Pharmacoeconomic Analysis ◽

Case Control ◽

Inflammatory Drug ◽

Anti Inflammatory ◽

Control Study

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Proton pump inhibitors are not associated with inflammatory myopathies: A case control study

Muscle & Nerve ◽

10.1002/mus.26336 ◽

2018 ◽

Vol 58 (6) ◽

pp. 855-857

Author(s):

Thomas Khoo ◽

Gillian E. Caughey ◽

Catherine Hill ◽

Vidya Limaye

Keyword(s):

Proton Pump Inhibitors ◽

Proton Pump ◽

Case Control Study ◽

Case Control ◽

Inflammatory Myopathies ◽

Control Study

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Efficacy and safety of vedolizumab in elderly patients with inflammatory bowel disease: a matched case–control study

Gastroenterology Report ◽

10.1093/gastro/goz041 ◽

2019 ◽

Vol 8 (4) ◽

pp. 306-311 ◽

Cited By ~ 1

Author(s):

Preeti Shashi ◽

Dharmesh Gopalakrishnan ◽

Malav P Parikh ◽

Bo Shen ◽

Gursimran Kochhar

Keyword(s):

Inflammatory Bowel Disease ◽

Elderly Patients ◽

Case Control Study ◽

The Elderly ◽

Mucosal Healing ◽

Case Control ◽

Elderly Group ◽

Efficacy And Safety ◽

Inflammatory Bowel ◽

Control Study

Abstract Background Vedolizumab was demonstrated to be safe and effective in adults with moderately to severely active inflammatory bowel disease (IBD) in clinical trials. However, there are limited data regarding its efficacy and safety in elderly patients. Methods This was a case–control study comparing the efficacy (measured by rates of mucosal healing and need for IBD surgery) and safety of vedolizumab in IBD among patients ≥65 years of age (the elderly group) vs those <65 years (the control group). The two groups were matched individually on a 1:4 ratio based on gender and type of IBD. Conditional logistic regression was used for stratified analysis to calculate odds ratios and confidence intervals. Results We included 25 IBD patients in the elderly group and 100 matched patients in the comparison group. Eighty patients had Crohn’s disease and 45 had ulcerative colitis. At baseline, the groups were comparable with regard to duration of IBD, prior anti-TNF therapy, and prior IBD surgery. The rate of mucosal healing on follow-up endoscopy was comparable between the elderly and control groups (50% vs 53%, P = 0.507). Although more patients in the elderly group required IBD-related surgery while on vedolizumab, the difference did not reach statistical significance (40% vs 19%, P = 0.282). Rates of vedolizumab-related adverse effects—rash, arthralgia, infections, infusion reactions, and dyspnea—were comparable between the two groups (all P > 0.05). Conclusions In a real-world setting, vedolizumab was demonstrated to have an efficacy and safety profile among elderly IBD patients that were comparable to younger controls.

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