The Risk of Epilepsy after Long-term Proton Pump Inhibitor Therapy

被引：7

作者：

Liang, Chih-Sung ^{[1
,2
]}

Bai, Ya-Mei ^{[3
,4
]}

Hsu, Ju-Wei ^{[3
,4
]}

Huang, Kai-Lin ^{[3
,4
]}

Ko, Nai-Ying ^{[5
]}

Tsai, Chia-Kuang ^{[6
]}

Yeh, Ta-Chuan ^{[7
]}

Chu, Hsuan-Te ^{[1
]}

Tsai, Shih-Jen ^{[3
,4
]}

Chen, Tzeng-Ji ^{[8
,9
]}

Chen, Mu-Hong ^{[3
,4
]}

机构：

[1] Natl Def Med Ctr, Triserv Gen Hosp, Dept Psychiat, Beitou Branch, Taipei, Taiwan

[2] Natl Def Med Ctr, Grad Inst Med Sci, Taipei, Taiwan

[3] Taipei Vet Gen Hosp, Dept Psychiat, Taipei, Taiwan

[4] Natl Yang Ming Chiao Tung Univ, Coll Med, Dept Psychiat, Taipei, Taiwan

[5] Natl Cheng Kung Univ & Hosp, Coll Med, Dept Nursing, Tainan, Taiwan

[6] Natl Def Med Ctr, Triserv Gen Hosp, Dept Neurol, Taipei, Taiwan

[7] Natl Def Med Ctr, Triserv Gen Hosp, Dept Psychiat, Taipei, Taiwan

[8] Taipei Vet Gen Hosp, Dept Family Med, Taipei, Taiwan

[9] Natl Yang Ming Chiao Tung Univ, Inst Hosp & Hlth Care Adm, Taipei, Taiwan

来源：

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2021年 / 87卷

关键词：

Proton pump inhibitor; Acid suppressant; Epilepsy; Seizures; Long-term treatment; HYPERPHOSPHORYLATED TAU; ALZHEIMERS-DISEASE; MOUSE MODEL; DISORDER; HYPEREXCITABILITY; HYPOMAGNESEMIA; LANSOPRAZOLE; ASSOCIATION; SEIZURES; INCREASE;

D O I：

10.1016/j.seizure.2021.03.008

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Prescription-event monitoring studies have reported incident epilepsy or seizures in proton pump inhibitor (PPI) recipients. We examined the risk of epilepsy after prolonged PPI exposure and determine what age group was at higher risk of epilepsy. Methods: We performed a case-control study nested within a sample of Taiwan National Health Insurance beneficiaries (n = 1,000,000). PPI users with subsequent epilepsy were selected as the case cohort. Controls were PPI users without subsequent epilepsy, matched for age, sex, PPI use indication, enrollment time, end point time, follow-up period, overall systemic health, and comorbidities. The total dose of PPI was defined as the cumulative defined daily dose (cDDD). Prolonged PPI use was defined as a cDDD > 365. A logistic regression analysis was performed. Population attributable risk was calculated. Results: Epilepsy occurred 4.13 years after the initiation of PPI use. PPI users with the highest risk of incident epilepsy received a cDDD > 365 [odds ratio = 1.63, 95% confidence interval = 1.37-1.95], followed by 121-365 cDDD (1.33, 1.18-1.51) and 31-20 cDDD (1.15, 1.02-1.29), compared to those receiving a cDDD < 30, after adjusting for potential confounders. Prolonged PPI use increased the risk of epilepsy in all age groups, and the risk was highest for those older than 80 years (3.11, 1.67-5.79). The population attributable risk was 12.2% (> 365 cDDD vs < 30 cDDD). Discussion: Prolonged PPI therapy was associated with an increased risk of epilepsy, particularly in the elderly population.

引用

页码：88 / 93

页数：6

共 42 条

[1] The Proton-Pump Inhibitor Lansoprazole Enhances Amyloid Beta Production [J].