Abstract
Background
Evidence on the effectiveness of proton pump inhibitors (PPI) as adjuvant therapy
to improve maldigestion in people with cystic fibrosis (pwCF) is limited and there
is increasing concern on possible side effects.
Methods
We conducted a matched cohort study based on paediatric and adult pwCF who received
PPI for ≥3 months. Treated patients were matched to a group of patients who never
received PPI using a nearest neighbour propensity score matching based on sex, year
of birth, CFTR genotype and pancreatic insufficiency.
Results
The study included 160 pwCF: 80 treated and 80 untreated patients. Over a median follow-up
of 2 years, no significant differences in changes in BMI z-score were detected between
groups (adjusted mean difference: 0.06, 95% CI: -0.17–0.30). At baseline 25% (n = 20) of the treated patients and 22.5% (n = 18) of the untreated patients had a positive culture for P. aeruginosa (Pa). At
follow-up percentages of Pa positive cultures increased to 47.5% (n = 38) in the treated group and to 26.3% (n = 21) in the untreated group (adjusted mean difference: 23.1%, 95% CI: 10.8–35.3).
Conclusions
Prolonged PPI therapy should be used cautiously in pwCF since it may increase the
risk of respiratory infection by Pa. In addition, such treatment does not seem to
improve nutritional status.
Keywords
Abbreviations:
BMIZ (Z-score of Body Mass Index), CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), GERD (Gastroesophageal reflux disease), Pa (Pseudomonas aeruginosa), PERT (Pancreatic Enzyme Replacement Therapy), ppFEV1 (Forced Expiratory Volume in one second as percent of predicted), PPI (Proton Pump Inhibitors), pwCF (People with Cystic Fibrosis), SMD (Standardized Mean Difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 14, 2022
Accepted:
September 3,
2022
Received:
March 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
