A197 INVESTIGATING THE PROTON-PUMP INHIBITOR USE PRECEDING AND POST AN INFLAMMATORY BOWEL DISEASE DIAGNOSIS
Bibliographic record
Abstract
Abstract Background Proton-pump inhibitors (PPI) have an impact on gut microbiome. The use of PPI has increased since the late 1980s and between 2007-2017, there were nearly 59 million PPIs dispensed annually in France.1 Considering that inflammatory bowel disease (IBD) affects persons of all races, a disease trigger for IBD may be a factor that can directly alter the intestinal immune response, or indirectly through changes in the gut microbiome. This raises the possibility that the advent use of PPI may be associated with the worldwide rise in IBD. Purpose We investigated whether increased use of PPI was associated with a diagnosis of IBD. Method The University of Manitoba IBD Epidemiology Database includes all Manitobans diagnosed with IBD between 1984 to 2018 with age, sex and geography-matched controls and comprehensive prescription drug data from April 1995. Subjects were considered to be users if they received 2 prescriptions of PPI. We assessed PPI prescriptions pre-diagnosis and for 3-years post-diagnosis of IBD. The absolute and relative rates were calculated and compared for PPI use pre- and post-IBD diagnosis. Result(s) A retrospective analysis was completed by analyzing 5920 subjects that were diagnosed with IBD after April 1996. Rates of PPI use in controls increased gradually from 1.5 to 6.5% over 15-years. Persons with IBD have a higher rate of PPI use peaking up to 17% within 1-year of IBD diagnosis with a rate ratio (RR) of 3.1 [95% CI 2.9 – 3.3]. Furthermore, persons with Crohn’s disease (CD) [RR= 4.2; 95% CI 3.7 – 4.6] were more likely to have been PPI users pre-diagnosis than persons with ulcerative colitis [RR= 2.4; 95% CI 2.2 – 2.7]. Important predictors of increased PPI use were older age, year of data collection and CD diagnosis. Conclusion(s) This retrospective analysis showed an increase in PPI use over the past 20-years among all Manitobans. Persons with IBD have higher PPI use within 1-year of their IBD diagnosis. It is possible that persons with IBD have an increase in acid peptic diseases or alternatively, the use of a PPI alters the gut microbiome increasing the risk for IBD diagnosis, or that some IBD symptoms are treated with PPI whether warranted or not. Future studies are needed to delineate whether the indication for ongoing PPI use is appropriate. References: 1Lassalle M, Le Tri T, Bardou M, et al. Use of proton pump inhibitors in adults in France: a nationwide drug utilization study. Eur J Clin Pharmacol. 2020;76(3):449-457. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".