Childhood acid-suppressant use may increase the risk of allergic diseases

Published: October 12, 2022

The maternal use of acid-suppressants during pregnancy has been found to be associated with increased risk of childhood asthma. What remains less certain however, is whether the use of these medications in early childhood will affect the maturing infant immune system and gut microbiome, subsequently leading to the development of childhood allergic diseases.

In this systematic-review and meta-analysis recently published in The Journal of Allergy and Clinical Immunology: In Practice, Song and colleagues synthesized data from 5 observational studies comprising over 1.1 million pediatric participants to determine associations between childhood acid-suppressant use and asthma, atopic dermatitis as well as allergic rhinitis. These results were adjusted for confounders including demographics, parental educational level and childhood use of antibiotics.

The authors found that the use of acid-suppressants during childhood increases the risk of development of asthma, atopic dermatitis, and allergic rhinitis by 44%, 12% and 40% respectively. This risk was increased when the exposure occurred during the first two years of life and also suggested the possibility of a dose-dependent effect. Randomized-controlled trials should be conducted to ascertain causal mechanisms that might explain these associations. With these findings in mind, pediatricians and primary-care physicians should prescribe these medications more judiciously, and according to established guidelines.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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