Characteristics of Children Receiving Proton Pump Inhibitors Continuously for Up to 11 Years Duration
Received 30 March 2006; received in revised form 5 July 2006; accepted 12 August 2006.
Objective
To characterize those pediatric patients who receive long-term proton pump inhibitors (PPIs) and to determine the safety of long-term use of PPIs in this population.
Study design
Patient databases were screened for long-term PPI use, defined as more than 9 months of continuous prescription, between 1989 and 2004.
Results
The median duration of PPI use in the 166 patients in the study group was 3 years (range, 0.75 to 11.25 years). A total of 80 patients used PPIs for 3 to 11 years duration; 35 of these for more than 5 years, and 15 for more than 8 years. Mean age at initial prescription was 7.8 years. At least 1 gastroesophageal reflux disease (GERD)-predisposing disorder was present in 79% of the patients; the major disorders were neuromotor (in 66%) and esophageal atresia (in 14.5%). No GERD-predisposing disorder was present in 35 patients (21%). Endoscopic findings included hiatal hernia in 39% and histologically proven Barrett’s esophagus in 4.8%. Omeprazole was used in 90% of the patients; lansoprazole, in 7%. Six adverse reactions seen in 4 patients were potentially related to PPI (nausea and diarrhea, skin rash, agitation, and irritability).
Conclusions
Children with underlying GERD-predisposing disorders compose the majority of long-term PPI users. Few adverse reactions to these drugs occur, and discontinuation of the drug is seldom indicated. These preliminary data suggest that PPIs may be efficacious and safe for continuous use for up to 11 years’ duration in children.
aDivision of Gastroenterology, BC Children’s Hospital/University of British Columbia, Vancouver, BC, Canada
bGastroenterology and Health Services Research Sections, Houston Department of Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX.
Reprint requests: Eric Hassall, MD, Division of Gastroenterology, BC Children’s Hospital, 4480 Oak St, Vancouver, BC V6H 3V4, Canada.
Supported by a grant from AstraZeneca Canada to the University of British Columbia. Dr. El-Serag is a VA HSR&D awardee (RCD 00-013-2). The study sponsor played no role in data collection, data processing, or writing of the report, or in the decision to submit the paper. The first and third authors collaborated in the writing of the first draft of the manuscript, with input from the second author. None of the authors received any payment for producing the manuscript.
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