Use of acid suppressing medications such as proton pump inhibitors (PPIs) and histamine-2 receptor agonists (H2Ras) in children is associated with more than 40% increase in the risk of asthma and allergic rhinitis, suggests a study published in The Journal of Allergy and Clinical Immunology: In Practice.¹ The risk for atopic dermatitis also increased by more than 10%.

A systematic review and meta-analysis of five observational studies, sourced from Embase, PubMed, Scopus and The Cochrane Library, involving 1,160,200 children was conducted to study the impact of acid suppressing medications on the risk of allergies such as atopic dermatitis, allergic rhinitis, allergic conjunctivitis, asthma and food allergies in children.

Children who were given acid suppressants during childhood were overall at a higher (44%) risk of asthma with a hazard ratio of 1.44. The risk for atopic dermatitis (12%) and allergic rhinitis (40%) were also increased with HR of 1.12 and 1.40, respectively. This risk was particularly significant in young children, below 2 years of age.

Three out of the five studies included in the meta-analysis found significantly higher risks (52%) for asthma with the use of proton pump inhibitors (HR 1.52), while two out of five studies showed similar high risks with histamine-2 receptor agonists (HR 1.4). Three studies showed significant association between acid suppressants and risk for food allergy (HR 1.61).

The authors have cautioned that the “overall quality of evidence was low”. However, clinicians should be aware of the association between the use of acid suppressing medications and the risk of allergic diseases such as asthma, allergic dermatitis in children and prescribe them judiciously in this age group.

Reference

1. Song HJJMD, et al. Childhood acid suppressants may increase allergy risk -a systematic review and meta-analysis. J Allergy Clin Immunol Pract. 2022 Oct 15;S2213-2198(22)01045-5. doi: 10.1016/j.jaip.2022.09.042.