Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Association between Antacid Exposure and Risk of Interstitial Lung Diseases

  • Soohyun Bae (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Gjustina Loloci (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Dong Yoon Lee (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Hye Jin Jang (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Jihyeon Jeong (Department of Statistics, Kyungpook National University) ;
  • Won-Il Choi (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine)
  • Received : 2023.07.11
  • Accepted : 2023.12.17
  • Published : 2024.04.30
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Abstract

Background: The mechanisms leading to lung fibrosis are still under investigation. This study aimed to demonstrate whether antacids could prevent the development of interstitial lung disease (ILD). Methods: This population-based longitudinal cohort study was conducted between January 2006 and December 2010 in South Korea. Eligible subjects were ≥40 years of age, exposed to proton pump inhibitors (PPI)±histamine-2 receptor antagonists (H-2 blockers) or H-2 blockers only, and had no history of ILD between 2004 and 2005. Exposure to antacids was defined as the administration of either PPI or H-2 receptor antagonists for >14 days, whereas underexposure was defined as antacid treatment administered for less than 14 days. Newly developed ILDs, including idiopathic pulmonary fibrosis (IPF), were counted during the 5-year observation period. The association between antacid exposure and ILD development was evaluated using adjusted Cox regression models with variables, such as age, sex, smoking history, and comorbidities. Results: The incidence rates of ILD with/without antacid use were 43.2 and 33.8/100,000 person-years, respectively and those of IPF were 14.9 and 22.9/100,000 person-years, respectively. In multivariable analysis, exposure to antacid before the diagnosis of ILD was independently associated with a reduced development of ILD (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.45 to 0.71; p<0.001), while antacid exposure was not associated with development of IPF (HR, 0.88; 95% CI, 0.72 to 1.09; p=0.06). Conclusion: Antacid exposure may be independently associated with a decreased risk of ILD development.

Keywords

Acknowledgement

We thank the participants of the Korean Health Insurance Cohort study and the National Health Insurance Service (NHIS) who developed the NHIS-NSC database. The views expressed in this article are those of the authors and do not necessarily represent the official position of the Korean NHIS.

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