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The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis
OBJECTIVE: Hypomagnesemia increases the risk of chondrocalcinosis and calcium pyrophosphate disease. We examined whether the use of drugs that can cause hypomagnesemia, diuretics and proton pump inhibitors (PPIs), increases the risk of chondrocalcinosis. METHODS: Participants in the Multicenter Oste...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207690/ http://dx.doi.org/10.1002/acr2.11260 |
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author | Felson, David T. Rabasa, Gabriela Chen, Xiaoyang LaValley, Michael Jafarzadeh, S. Reza Lewis, Cora E. Torner, James Nevitt, Michael C. Misra, Devyani |
author_facet | Felson, David T. Rabasa, Gabriela Chen, Xiaoyang LaValley, Michael Jafarzadeh, S. Reza Lewis, Cora E. Torner, James Nevitt, Michael C. Misra, Devyani |
author_sort | Felson, David T. |
collection | PubMed |
description | OBJECTIVE: Hypomagnesemia increases the risk of chondrocalcinosis and calcium pyrophosphate disease. We examined whether the use of drugs that can cause hypomagnesemia, diuretics and proton pump inhibitors (PPIs), increases the risk of chondrocalcinosis. METHODS: Participants in the Multicenter Osteoarthritis (MOST) Study obtained weight‐bearing knee radiographs, and their medication use was recorded at baseline and 30‐, 60‐, 84‐, and 144‐month examinations. We read radiographs serially for chondrocalcinosis and characterized incident chondrocalcinosis when it first appeared. We classified diuretic use as thiazide, loop, and other. To test drug effects on incident chondrocalcinosis at each interval (eg, 30‐60 months), we excluded persons with chondrocalcinosis at the interval’s beginning. For each drug, we evaluated exposure at the beginning and end of the interval. We conducted knee‐based analyses using Bayesian mixed‐effects discrete time survival models adjusted for age, sex, body mass index, radiographic osteoarthritis, race, and clinic site. RESULTS: Of 5272 knees, 196 developed chondrocalcinosis. Thiazide use (21.7% of examinations) and PPI use (13.7%) were common. Neither loop nor other diuretic use was associated with incident chondrocalcinosis. Thiazide use at the beginning and end of the interval of incidence conferred a high risk (hazard ratio [HR] = 2.18; 95% confidence interval [CI] 1.23‐3.89), but use at the beginning of the interval was not associated with risk (HR = 1.04). PPI use at the interval’s beginning increased risk of chondrocalcinosis (HR = 2.29; 95% CI 1.37‐3.79). CONCLUSION: Thiazide diuretics, but not other diuretics, and PPI use probably increase the risk of chondrocalcinosis. These findings may have important clinical implications. |
format | Online Article Text |
id | pubmed-8207690 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82076902021-06-25 The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis Felson, David T. Rabasa, Gabriela Chen, Xiaoyang LaValley, Michael Jafarzadeh, S. Reza Lewis, Cora E. Torner, James Nevitt, Michael C. Misra, Devyani ACR Open Rheumatol Original Articles OBJECTIVE: Hypomagnesemia increases the risk of chondrocalcinosis and calcium pyrophosphate disease. We examined whether the use of drugs that can cause hypomagnesemia, diuretics and proton pump inhibitors (PPIs), increases the risk of chondrocalcinosis. METHODS: Participants in the Multicenter Osteoarthritis (MOST) Study obtained weight‐bearing knee radiographs, and their medication use was recorded at baseline and 30‐, 60‐, 84‐, and 144‐month examinations. We read radiographs serially for chondrocalcinosis and characterized incident chondrocalcinosis when it first appeared. We classified diuretic use as thiazide, loop, and other. To test drug effects on incident chondrocalcinosis at each interval (eg, 30‐60 months), we excluded persons with chondrocalcinosis at the interval’s beginning. For each drug, we evaluated exposure at the beginning and end of the interval. We conducted knee‐based analyses using Bayesian mixed‐effects discrete time survival models adjusted for age, sex, body mass index, radiographic osteoarthritis, race, and clinic site. RESULTS: Of 5272 knees, 196 developed chondrocalcinosis. Thiazide use (21.7% of examinations) and PPI use (13.7%) were common. Neither loop nor other diuretic use was associated with incident chondrocalcinosis. Thiazide use at the beginning and end of the interval of incidence conferred a high risk (hazard ratio [HR] = 2.18; 95% confidence interval [CI] 1.23‐3.89), but use at the beginning of the interval was not associated with risk (HR = 1.04). PPI use at the interval’s beginning increased risk of chondrocalcinosis (HR = 2.29; 95% CI 1.37‐3.79). CONCLUSION: Thiazide diuretics, but not other diuretics, and PPI use probably increase the risk of chondrocalcinosis. These findings may have important clinical implications. John Wiley and Sons Inc. 2021-05-02 /pmc/articles/PMC8207690/ http://dx.doi.org/10.1002/acr2.11260 Text en © 2021 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Felson, David T. Rabasa, Gabriela Chen, Xiaoyang LaValley, Michael Jafarzadeh, S. Reza Lewis, Cora E. Torner, James Nevitt, Michael C. Misra, Devyani The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title | The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title_full | The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title_fullStr | The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title_full_unstemmed | The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title_short | The Association of Diuretics and Proton Pump Inhibitors With Chondrocalcinosis |
title_sort | association of diuretics and proton pump inhibitors with chondrocalcinosis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207690/ http://dx.doi.org/10.1002/acr2.11260 |
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