Acid suppressant medications and the risk of allergic diseases

Expert Rev Clin Immunol. 2018 Sep;14(9):771-780. doi: 10.1080/1744666X.2018.1512405. Epub 2018 Aug 24.

Abstract

Acid suppressant medications (ASMs), such as proton pump inhibitors and histamine-2 receptor antagonists, are used often and throughout the lifespan. These medications have been linked to the development of a variety of allergic diseases. Areas covered: This review discusses prior studies investigating the association between acid ASM exposure and the development of allergic diseases. We performed a thorough literature search to identify potentially relevant studies for inclusion. In summary, exposure to these medications prenatally, in childhood and in adulthood, may increase the risk of allergic diseases. The current evidence is limited by primarily observational study design and potential bias and confounding. The mechanism of action is not yet known, but there are several proposed theories. Expert commentary: There is a growing body of evidence to support that exposure to acid ASMs increases the risk of developing allergic diseases. Further research is needed to not only clarify this relationship but to define the potential mechanism of action. If further research confirms these observations, we believe that could warrant changes in the patterns of prescribing and use of acid ASMs.

Keywords: Acid suppressant medication; allergy; asthma; gastroesophageal reflux disease; histamine-2 receptor antagonist; prenatal and proton pump inhibitor.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-Allergic Agents / adverse effects*
  • Anti-Allergic Agents / therapeutic use
  • Bias
  • Confounding Factors, Epidemiologic
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Female
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / drug therapy*
  • Histamine Antagonists / adverse effects*
  • Humans
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / etiology
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Proton Pump Inhibitors / adverse effects*
  • Proton Pump Inhibitors / therapeutic use
  • Risk

Substances

  • Anti-Allergic Agents
  • Histamine Antagonists
  • Proton Pump Inhibitors