The following is a summary of the “Childhood Acid Suppressants May Increase Allergy Risk—A Systematic Review and Meta-Analysis,” published in the January 2023 issue of Allergy and Clinical Immunology by Song et al.
The purpose of this study was to systematically review and synthesize the evidence linking the use of acid suppressants in childhood to the emergence of allergic diseases in adulthood. Methodical searches were conducted in PubMed, Embase, The Cochrane Library, and Scopus. Acid suppressant use in children and its association with allergic outcomes like asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis, and food allergies were included in their meta-analysis of observational and interventional studies.
A PROSPERO-registered protocol was used to extract key data and assess the risk of bias in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Mixed-effects models were utilized to pool optimally adjusted estimates, and I2 was used to quantify heterogeneity. Subgroup and sensitivity analyses were also performed. The Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the overall quality of the evidence. There were 5 observational studies with a low to moderate risk of bias were included in this review.
Prevalence of asthma (hazard ratio [HR] = 1.44, 95% CI = 1.31-1.58), atopic dermatitis (Hazard ratio (HR) = 1.12, 95% CI = 1.10-1.14), and allergic rhinitis (HR = 1.40, 95% CI = 1.24-1.58), all increased significantly with acid-suppressant use in children.
Age, race, gender, marital status, and parental education level were controlled to establish these associations. The overall standard of proof was quite low. In children, taking acid-reducing medications may increase the likelihood of developing asthma, eczema, or hay fever later in life. However, more extensive research is required, ideally in randomized controlled trials. More stringent guidelines should be advocated and used with caution when administering these drugs to children.
Source: sciencedirect.com/science/article/abs/pii/S2213219822010455
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