geoffrey modest medical blogs

  A recent Belgian study found that the use of proton pump inhibitors (PPIs) is associated with increased exacerbations of COPD and asthma (which they refer to as chronic obstructive airway diseases, COADs) in a dose-response way: see copd inc with PPIs Chest2026 in dropbox, or DOI: https://doi.org/10.1016/j.chest.2026.01.002   Details : -- 932,135 patients (with a total of 1,084,446 person-years of follow-up) were identified using the Belgian nationwide claims-based data of adult patients receiving long-term medication for COADs (ie, having at least two dispensings of medication for obstructive lung diseases) between 2017 and 2022 -- patients on histamine type 2 receptor antagonists (H2RAs) were excluded (at that time there was a carcinogen impurity found in ranitidine, the most prescribed H2 blocker, that was taken off the market), -- 416,087 patients (44.6%) were also receiving PPIs: -- mean age 61, 54% female, 29% low socioeconomic status (assessed by their medical cover...

      given my general feelings that gabapentinoids (gabapentin and pregabalin) are dramatically over-prescribed and often for inappropriate indications, this blog will address issues of major complications in terms of asthma and COPD as well as heart failure associated with their use (see gabapentinoids inc asthma Thorax2025  in dropbox, or https:// doi. org/ 10. 1136/ thorax- 2025- 223240).  Details : -- researchers in Japan accessed their National Database of Health Insurance Claims and Specific Health Check-ups (NDB) from 2015 to 2023     -- this database has data from all public insurers in Japan, resulting in nearly complete coverage of hospitals nationwide, with demographic data on each patient as well as diagnoses, examinations, and treatments from both inpatient and outpatient settings -- the patients included were at least 40 years old (that is when routine checkups are done in ...

  A population-based observational study found that gabapentinoids (gabapentin and pregabalin) were associated with severe COPD exacerbations (see   gabapentin assoc severe COPD AnnIntMed2024  in dropbox, or  doi:10.7326/M23-0849)   Details: -- a large data-mining study from Québec access ed  three computerized healthcare databases, collecting information on demographics, medical services,  and  dispensed outpatient prescriptions. this included information on medical services for all Québec residents (though one of the databases only included those who did not have private medication insurance, 43% of the population ). These researchers also accessed   information on  all hospitalizations, procedures, and vital statistics including date, cause, and place of death -- there were  some  differences in the demographics and comorbidities of those  individuals  on gabapentinoids ,  based on whether they were used ...