UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis

Host, LV; Campochiaro, C; Afonso, A; Nihtyanova, SI; Denton, CP; Ong, VH; (2021) High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis. Rheumatology , 60 (2) pp. 849-854. 10.1093/rheumatology/keaa332. Green open access

[thumbnail of PPI_Calc-Ong-Denton UCL upload 2020.pdf]
Preview
Text
PPI_Calc-Ong-Denton UCL upload 2020.pdf - Accepted Version

Download (1MB) | Preview

Abstract

OBJECTIVE: To investigate the association between proton pump inhibitor (PPI) use and the presence and severity of calcinosis in SSc. METHODS: We analysed data from two SSc cohorts from a single centre. Cohort 1 included 199 patients reviewed over 10 years, for whom retrospective data on PPI use and calcinosis were available. Cohort 2 was recruited prospectively and included 215 consecutive patients, who underwent clinical assessment. Outcomes of interest were presence of current calcinosis (CC) or calcinosis at any time (CAT). RESULTS: The cohort 1 data analysis showed that among patients on standard dose PPI 20% had calcinosis, while in those on high doses of PPI calcinosis was present in 39% (P = 0.003). Analysis of the data from cohort 2 confirmed these findings, demonstrating that the odds of CAT increased significantly with longer PPI exposure [odds ratio (OR) 1.04, 95% CI: 1.02, 1.06; P < 0.001], longer disease duration (OR 1.08, 95% CI: 1.05, 1.12; P < 0.001) and greater age (OR 1.03, CI: 1.01, 1.05; P = 0.010). Multivariable logistic regression showed that higher exposure to PPI remained a significant predictor of calcinosis, with PPI exposure >10 years increasing the risk of CAT >6-fold, compared with no PPI (OR 6.37, 95% CI: 1.92, 21.17; P = 0.003) after adjusting for disease duration and antibodies. CONCLUSION: We confirm a significant association between high PPI exposure with severity of calcinosis in SSc. Given the clinical impact of calcinosis and reflux in SSc, PPI exposure as a potentially modifiable risk factor for calcinosis requires further evaluation.

Type: Article
Title: High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/rheumatology/keaa332
Publisher version: https://doi.org/10.1093/rheumatology/keaa332
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: calcinosis, protein pump inhibitors, systemic sclerosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10109481
Downloads since deposit
81Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item