Proton Pump Inhibitor Use and Its Association With Asthma: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
Background: Asthma is a prevalent chronic respiratory condition marked by airway inflammation and hyperresponsiveness, significantly impacting quality of life. Emerging evidence suggests a potential association between proton pump inhibitor (PPI) use and an increased risk of asthma. This systematic review and meta‐analysis assessed the relationship between PPI use and the development or exacerbation of asthma. Methods: A systematic search of PubMed, Web of Science, and Embase databases was conducted, covering studies published from the inception of the database to July 12, 2024. Observational studies examining the association between PPI use and asthma risk were included. Two reviewers independently extracted data using Nested Knowledge software, with study quality assessed via the Newcastle–Ottawa Scale. A random‐effects meta‐analysis was performed, pooling odds ratios (ORs) and hazard ratios (HRs) to assess the association, with heterogeneity evaluated via the I 2 statistic. Results: Fourteen studies, conducted between 2009 and 2024 and involving over 1.7 million participants, met the inclusion criteria. The pooled HR showed a 38% increased risk of asthma among PPI users compared to nonusers (HR, 1.38; 95% CI, 1.14–1.62). OR analysis indicated a 29% higher risk (OR, 1.29; 95% CI, 1.23–1.35). PPI users had an 81% higher risk compared to histamine H 2 receptor antagonist (H 2 RA) users (HR, 1.81; 95% CI, 1.09–2.53), and asthma patients using PPIs were 61% more likely to experience exacerbations (OR, 1.61; 95% CI, 1.42–1.80). Conclusion: PPI use is associated with an increased risk of asthma. These findings underscore the need for cautious prescribing and further investigation into underlying mechanisms.
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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 | 0.009 | 0.021 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.035 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".