Do the omeprazole family compounds exert a protective effect against influenza-like illness?

Roberto Gasparini,Piero Luigi Lai,Daniela Amicizia,Sara Boccalini,Francesca Casabona,Maria Luisa Cristina,Stefania Rossi,Donatella Panatto,Cecilia Trucchi

doi:10.1186/1471-2334-14-297

Abstract

BackgroundInfections by influenza viruses place a heavy burden on public health and economies worldwide. Although vaccines are the best weapons against influenza, antiviral drugs could offer an opportunity to alleviate the burden of influenza. Since omeprazole family compounds block the “proton pump”, we hypothesized that they could interfere with the mechanism of fusion of the virus envelope and endosomal membrane, thereby hindering the M2 proton pump mechanism of influenza viruses.MethodsA matched case-control study was performed in 2010-2011 in Italy. Cases were subjects aged over 18 years with a diagnosis of Influenza-like Illness (ILI); 254 case-control pairs were recruited. A multivariable conditional logistic regression analysis was used to assess the association between the prevention of ILI and the administration of omeprazole family compounds. The interaction between omeprazole family compounds and influenza vaccination was also examined.ResultsAfter control for potential confounders, subjects treated with omeprazole family compounds displayed a lower risk of catching ILI (ORadj = 0.29, 95% CI: 0.15-0.52). The risk of ILI in unvaccinated non-OFC users was about six times than that in vaccinated OFC users.ConclusionsAlthough confirmation is necessary, these results suggest that omeprazole family compounds could be profitably used in the prevention of ILI.

Highlights

Infections by influenza viruses place a heavy burden on public health and economies worldwide
We found Relative Excess Risk due to Interaction (RERI) = 4.34; this means that, owing to the presence of interaction, the Influenza-like Illness (ILI) risk for unvaccinated non-Omeprazole Family Compounds (OFC) users was higher than would be expected in the absence of interaction on an additive scale, and that the test for interaction was statistically significant (RERI = 4.34; 95% Confidence Interval (CI): 1.46–7.26)
Our analysis showed that respiratory and cardiovascular diseases were not associated with a higher risk of catching ILI (Table 4), whereas it is well known that these underlying pathologies are associated with a higher risk of hospitalization for influenza and pneumonia

Summary

Introduction

Infections by influenza viruses place a heavy burden on public health and economies worldwide. In Italy, considering seasonal epidemic periods alone, it has been estimated that 25 million cases of Influenza-like Illness (ILI) occurred from 1999 to 2008, with an average of 2.5 million cases per year [3]. Molinari et al estimated that, on the basis of the US population in 2003, annual influenza epidemics resulted in an average of 610,660 life-years lost, 3.1 million days of hospitalization and 31.4 million outpatient visits. These authors estimated that, of the 31.4 million outpatient visits, 9.6 and 14.3 million involved subjects aged 18-64 years and over 65 years, respectively [4]

Methods

Results

Discussion

Conclusion