Proton Pump Inhibitors Impact Outcomes for Patients With Inflammatory Bowel Disease Receiving Infliximab

Investigators assessed whether PPI therapy is associated with decreased remission rates and increased hospitalizations among patients with IBD receiving infliximab.

The following article is a part of conference coverage from the Advances in Inflammatory Bowel Diseases 2021 Annual Meeting , held from December 9 to 11, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from AIBD 2021.


Patients with inflammatory bowel disease (IBD) on infliximab have a higher incidence of hospitalization when there is concurrent proton pump inhibitor (PPI) therapy, according to research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting, held from December 9 to 11, 2021, in Orlando, Florida and virtually.

Investigators performed a cohort study including 104 patients with IBD on infliximab therapy. They aimed to assess whether PPI therapy in this patient population was associated with lower rates of clinical remission and increased rates of hospitalization. Minimum follow-up was 54 weeks. The primary endpoints were deep remission at week 54 and need for hospitalization, treatment with corticosteroids, or abdominal surgery, following induction of infliximab.

In total, 53.8% of patients included in the analysis were women with a mean age of 38.2±13.1 years. The majority of patients (74%) had CD and 20.2% were undergoing PPI therapy. 

After 54 weeks, patients receiving PPIs had significantly lower rates of remission compared with non-PPI patients (7.7% vs 28.3%; P =.034); however, the difference was minimized when additional confounders such as smoking habit, age, and sex were factored in (odds ratio [OR], 0.16; 95% CI, 0.02-1.63; P =.121). IBD-related hospitalization was 3-times higher in patients receiving PPIs, even after adjusting for confounders (OR, 3.22; 95% CI, 1.11-9.34; P =.04).

Researchers believe, “These findings emphasize the importance of restricting PPI treatment to those with a clear clinical indication, especially in this set of patients.”

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Macedo SV, Lima CT, Freitas M, et al. Proton pump inhibitor therapy: providing “acid” outcomes in patients with inflammatory bowel disease under infliximab treatment. Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P020.