Proton pump inhibitors and the risk of XXXX in older @entity1 : a population-based cohort study.

@entity1 @entity810 @entity1986
BACKGROUND: Proton pump inhibitors (PPIs) cause @entity1986 and are an underappreciated cause of @entity810 . We examined the risk of @entity810 and acute @entity1986 in a large population of older @entity1 receiving PPIs. METHODS: We conducted a population-based study involving Ontario residents aged 66 years and older who initiated PPI therapy between Apr. 1, 2002, and Nov. 30, 2011. We used propensity score matching to establish a highly comparable reference group of control @entity1 . The primary outcome was hospital admission with @entity810 within 120 days, and a secondary analysis examined acute @entity1986 . We used Cox proportional hazards regression to adjust for differences between groups. RESULTS: We studied 290  592 individuals who commenced PPI therapy and an equal number of matched controls. The rates of @entity810 (13.49 v. 5.46 per 1000 @entity1 -years, respectively; hazard ratio [HR] 2.52, 95% CI 2.27 to 2.79) and acute @entity1986 (0.32 vs. 0.11 per 1000 @entity1 -years; HR 3.00, 95% CI 1.47 to 6.14) were higher among @entity1 given PPIs than among controls. INTERPRETATION: In our study population of older adults, those who started PPI therapy had an increased risk of @entity810 and acute @entity1986 . These are potentially reversible conditions that may not be readily attributed to drug treatment. Clinicians should appreciate the risk of acute @entity1986 during treatment with PPIs, monitor @entity1 appropriately and discourage the indiscriminate use of these drugs.
