PMID- 29161254
OWN - NLM
STAT- MEDLINE
DCOM- 20171219
LR  - 20220129
IS  - 1549-1676 (Electronic)
IS  - 1549-1277 (Print)
IS  - 1549-1277 (Linking)
VI  - 14
IP  - 11
DP  - 2017 Nov
TI  - Lansoprazole use and tuberculosis incidence in the United Kingdom Clinical 
      Practice Research Datalink: A population based cohort.
PG  - e1002457
LID - 10.1371/journal.pmed.1002457 [doi]
LID - e1002457
AB  - BACKGROUND: Recent in vitro and animal studies have found the proton pump 
      inhibitor (PPI) lansoprazole to be highly active against Mycobacterium 
      tuberculosis. Omeprazole and pantoprazole have no activity. There is no evidence 
      that, in clinical practice, lansoprazole can treat or prevent incident 
      tuberculosis (TB) disease. METHODS AND FINDINGS: We studied a cohort of new users 
      of lansoprazole, omeprazole, or pantoprazole from the United Kingdom Clinical 
      Practice Research Datalink to determine whether lansoprazole users have a lower 
      incidence of TB disease than omeprazole or pantoprazole users. Negative control 
      outcomes of myocardial infarction (MI) and herpes zoster were also studied. 
      Multivariable Cox proportional hazards regression was used to adjust for 
      potential confounding by a wide range of factors. We identified 527,364 
      lansoprazole initiators and 923,500 omeprazole or pantoprazole initiators. 
      Lansoprazole users had a lower rate of TB disease (n = 86; 10.0 cases per 100,000 
      person years; 95% confidence interval 8.1-12.4) than omeprazole or pantoprazole 
      users (n = 193; 15.3 cases per 100,000 person years; 95% confidence interval 
      13.3-17.7), with an adjusted hazard ratio (HR) of 0.68 (0.52-0.89). No 
      association was found with MI (adjusted HR 1.04; 95% confidence interval 
      1.00-1.08) or herpes zoster (adjusted HR 1.03; 95% confidence interval 
      1.00-1.06). Limitations of this study are that we could not determine whether TB 
      disease was due to reactivation of latent infection or a result of recent 
      transmission, nor could we determine whether lansoprazole would have a beneficial 
      effect if given to people presenting with TB disease. CONCLUSIONS: In this study, 
      use of the commonly prescribed and cheaply available PPI lansoprazole was 
      associated with reduced incidence of TB disease. Given the serious problem of 
      drug resistance and the adverse side effect profiles of many TB drugs, further 
      investigation of lansoprazole as a potential antituberculosis agent is warranted.
FAU - Yates, Tom A
AU  - Yates TA
AD  - Institute for Global Health, University College London, Institute of Child 
      Health, London, United Kingdom.
FAU - Tomlinson, Laurie A
AU  - Tomlinson LA
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
FAU - Bhaskaran, Krishnan
AU  - Bhaskaran K
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
FAU - Langan, Sinead
AU  - Langan S
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
FAU - Thomas, Sara
AU  - Thomas S
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
FAU - Smeeth, Liam
AU  - Smeeth L
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
FAU - Douglas, Ian J
AU  - Douglas IJ
AUID- ORCID: 0000-0002-8970-1406
AD  - London School of Hygiene & Tropical Medicine, London, United Kingdom.
LA  - eng
GR  - Wellcome Trust/United Kingdom
GR  - 205039/Z/16/Z/Wellcome Trust/United Kingdom
GR  - G0802403/MRC_/Medical Research Council/United Kingdom
GR  - NIHR/CS/010/014/DH_/Department of Health/United Kingdom
PT  - Clinical Trial
PT  - Journal Article
DEP - 20171121
PL  - United States
TA  - PLoS Med
JT  - PLoS medicine
JID - 101231360
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - D8TST4O562 (Pantoprazole)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Lansoprazole/*therapeutic use
MH  - Male
MH  - Omeprazole/therapeutic use
MH  - Pantoprazole
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Tuberculosis/*drug therapy/*epidemiology
MH  - United Kingdom/epidemiology
PMC - PMC5697821
COIS- I have read the journal's policy and the authors of this manuscript have the 
      following competing interests: TY has previously worked on studies that received 
      support from Pasante, GlaxoSmithKline, and Sanofi, but did not benefit 
      financially from these arrangements.
EDAT- 2017/11/22 06:00
MHDA- 2017/12/20 06:00
PMCR- 2017/11/21
CRDT- 2017/11/22 06:00
PHST- 2017/02/22 00:00 [received]
PHST- 2017/10/23 00:00 [accepted]
PHST- 2017/11/22 06:00 [entrez]
PHST- 2017/11/22 06:00 [pubmed]
PHST- 2017/12/20 06:00 [medline]
PHST- 2017/11/21 00:00 [pmc-release]
AID - PMEDICINE-D-17-00633 [pii]
AID - 10.1371/journal.pmed.1002457 [doi]
PST - epublish
SO  - PLoS Med. 2017 Nov 21;14(11):e1002457. doi: 10.1371/journal.pmed.1002457. 
      eCollection 2017 Nov.