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Associations of Antibiotics, Hormonal Therapies, Oral Contraceptives, and Long-Term Nsaids With Inflammatory Bowel Disease: Results From the Prospective Urban Rural Epidemiology (Pure) Study Publisher Pubmed



Narula N1, 2 ; Wong ECL1 ; Pray C1 ; Marshall JK1 ; Rangarajan S2 ; Islam S2 ; Bahonar A3 ; Alhabib KF4 ; Kontsevaya A5 ; Ariffin F6 ; Co HU7 ; Al Sharief W8 ; Szuba A9 ; Wielgosz A10 Show All Authors
Authors
  1. Narula N1, 2
  2. Wong ECL1
  3. Pray C1
  4. Marshall JK1
  5. Rangarajan S2
  6. Islam S2
  7. Bahonar A3
  8. Alhabib KF4
  9. Kontsevaya A5
  10. Ariffin F6
  11. Co HU7
  12. Al Sharief W8
  13. Szuba A9
  14. Wielgosz A10
  15. Diaz ML11
  16. Yusuf R12
  17. Kruger L13
  18. Soman B14
  19. Li Y15
  20. Wang C15
  21. Yin L15
  22. Mirrakhimov E16
  23. Lanas F17
  24. Davletov K18
  25. Rosengren A19
  26. Lopezjaramillo P20
  27. Khatib R21, 22
  28. Oguz A23
  29. Iqbal R24
  30. Yeates K25
  31. Avezum A26
  32. Reinisch W27
  33. Moayyedi P1, 2
  34. Yusuf S2
Show Affiliations
Authors Affiliations
  1. 1. Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
  2. 2. Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
  3. 3. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
  5. 5. National Research Center for Therapy and Preventive Medicine, Russian Federation, Moscow, Russian Federation
  6. 6. Primary Care Medicine, Faculty of Medicine Universiti Teknologi MARA, Selangor, Malaysia
  7. 7. University of the Philippines College of Medicine, Manila, Philippines
  8. 8. Family Medicine Department, Medical Education and Research Department, Dubai Health Authority, Dubai, United Arab Emirates
  9. 9. Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Wroclaw, Poland
  10. 10. University of Ottawa Heart Institute, Ottawa, ON, Canada
  11. 11. Estudios Clinicos Latinoamerica Rosario, Santa Fe, Argentina
  12. 12. Independent University, Bashundhara R/A, Dhaka, Bangladesh
  13. 13. Africa Unit for Transdisciplinary Health Research, Potchefstroom, South Africa
  14. 14. Health Action by People, Thiruvananthapuram, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, Trivandrum, India
  15. 15. Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
  16. 16. Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  17. 17. Universidad de La Frontera, Temuco, Chile
  18. 18. Al-Farabi Kazakh National University, Health Research Institute, Almaty, Kazakhstan
  19. 19. Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Vastra Gotaland Region Region, Sweden
  20. 20. Masira Research Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia
  21. 21. Advocate Aurora Research Institute, Advocate Aurora Health, Downers Grove, IL, United States
  22. 22. Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
  23. 23. Istanbul Medeniyet University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkiye
  24. 24. Department of Community Health Sciences, Aga Khan University, Sindh, Karachi City, Pakistan
  25. 25. Department of Medicine, Queen's University, Kingston, ON, Canada
  26. 26. International Research Center, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil
  27. 27. Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

Source: Clinical Gastroenterology and Hepatology Published:2023


Abstract

Background & Aims: Several medications have been suspected to contribute to the etiology of inflammatory bowel disease (IBD). This study assessed the association between medication use and the risk of developing IBD using the Prospective Urban Rural Epidemiology cohort. Methods: This was a prospective cohort study of 133,137 individuals between the ages of 20 and 80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed up prospectively at least every 3 years. The main outcome was the development of IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) were evaluated. Results are presented as adjusted odds ratios (aORs) with 95% CIs. Results: During a median follow-up period of 11.0 years (interquartile range, 9.2–12.2 y), there were 571 incident IBD cases (143 CD and 428 UC). Incident IBD was associated significantly with baseline antibiotic (aOR, 2.81; 95% CI, 1.67–4.73; P =.0001) and hormonal medication use (aOR, 4.43; 95% CI, 1.78–11.01; P =.001). Among females, previous or current oral contraceptive use also was associated with IBD development (aOR, 2.17; 95% CI, 1.70–2.77; P <.001). Nonsteroidal anti-inflammatory drug users also were observed to have increased odds of IBD (aOR, 1.80; 95% CI, 1.23–2.64; P =.002), which was driven by long-term use (aOR, 5.58; 95% CI, 2.26–13.80; P <.001). All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusions: Antibiotics, hormonal medications, oral contraceptives, and long-term nonsteroidal anti-inflammatory drug use were associated with increased odds of incident IBD after adjustment for covariates. © 2023 AGA Institute
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