Use and Incidence of Adverse Effects of Proton Pump Inhibitors in Patients with Cystic Fibrosis.

Abstract

To evaluate the incidence of adverse effects associated with chronic proton pump inhibitor (PPI) use as well as the dosing, indication, and duration of use of PPIs in the cystic fibrosis (CF) population at a pediatric academic medical center. Study design was a retrospective chart review evaluating patients with CF who were prescribed a PPI for at least 6months (PPI group) or patients with CF who had never been prescribed a PPI (control group) from June 1, 2014, to May 31, 2015. The study enrolled 126 patients in the PPI group and 49 patients in the control group. Forty-four patients (34.9%) had an indication for both gastroesophageal reflux and enzyme enhancement, with an average PPI daily dose of 1mg/kg/day. Twenty-one patients (16.7%) in the PPI group had an incidence of hypomagnesemia compared with one patient (2%) in the control group (p=0.097). Overall, 75 patients (59.6%) receiving chronic PPI therapy had at least one pulmonary exacerbation compared with 12 patients (24.5%) in the control group (p<0.001). No significant difference was noted in the incidence of hypocalcemia, low bone mineral density, or positive Clostridium difficile toxin between the two groups. The PPI group had a higher risk of pulmonary exacerbation compared with the control group. Further studies are needed to assess adverse effects associated with chronic PPI use in patients with CF.