{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T06:23:03Z","timestamp":1789885383685,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,25]],"date-time":"2012-01-25T00:00:00Z","timestamp":1327449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"HealthCore, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Proton pump inhibitors (PPIs) and corticosteroids are commonly prescribed drugs; however, each has been associated with fracture and community\u2010acquired pneumonia. How physicians select patients for co\u2010therapy may have implications for potential additive or synergistic toxicities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of 13\u2009749 incident corticosteroid users with no prior PPI exposure using the HealthCore Integrated Research Database<jats:sup>SM<\/jats:sup>. We used logistic regression to evaluate the association between PPI initiation in the first 30\u2009days of steroid therapy and corticosteroid dose, clinical risk factors including comorbid diseases, and medication use including prescription nonsteroidal anti\u2010inflammatory drugs (NSAIDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A new PPI prescription within 30\u2009days of starting corticosteroids was filled by 1050 patients (7.6%). PPI use was associated with the number of baseline comorbid conditions (OR\u2009=\u20091.21 for each additional condition, 95%CI\u2009=\u20091.13\u20131.28), recent hospitalization (OR\u2009=\u20094.71, 95%CI\u2009=\u20094.02\u20135.52), prednisone dose higher than 40\u2009mg\/day (OR\u2009=\u20091.87, 95%CI\u2009=\u20091.45\u20132.41), history of gastroesophageal reflux or gastric ulcer disease (OR\u2009=\u20091.54, 95%CI\u2009=\u20091.24\u20131.91), renal insufficiency (OR\u2009=\u20092.06, 95%CI\u2009=\u20091.73\u20132.46), and liver disease (OR\u2009=\u20091.82, 95%CI\u2009=\u20091.45\u20132.28). The concomitant use of prescription NSAIDs was also associated with PPI use (OR\u2009=\u20091.89, 95%CI\u2009=\u20091.32\u20132.70); however, the total use of PPIs in this group was low (6.3%, 95%CI\u2009=\u20094.4\u20138.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, PPI therapy among corticosteroid users was uncommon, even among those with risk factors for gastrointestinal toxicity. PPI use was significantly more common among patients who had recently been hospitalized, had a greater burden of comorbid illness, or were receiving high daily doses of corticosteroids. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.2350","type":"journal-article","created":{"date-parts":[[2012,1,25]],"date-time":"2012-01-25T12:38:13Z","timestamp":1327495093000},"page":"366-374","source":"Crossref","is-referenced-by-count":20,"title":["Factors associated with the initiation of proton pump inhibitors in corticosteroid users"],"prefix":"10.1002","volume":"21","author":[{"given":"Jeffrey C.","family":"Munson","sequence":"first","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics University of Pennsylvania  Philadelphia PA USA"},{"name":"Dartmouth Medical School  Hanover NH USA"},{"name":"Veterans Affairs Medical Center  White River Junction VT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Wahl","sequence":"additional","affiliation":[{"name":"HealthCore, Inc.  Wilmington DE USA"},{"name":"Harvard School of Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Daniel","sequence":"additional","affiliation":[{"name":"HealthCore, Inc.  Wilmington DE USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Kimmel","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Hennessy","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2026"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.03.055"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-009-0891-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.94"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2010.12.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.24.2947"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-008-9170-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.092129"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04284.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.16.1955"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1715"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181b5f27d"},{"issue":"6","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.7326\/0003-4819-149-6-200809160-00005","article-title":"Proton\u2010pump inhibitor use and the risk for community\u2010acquired pneumonia","volume":"149","author":"Sarkar M","year":"2008","journal-title":"Ann Intern Med"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1978"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.28.8.951"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1337-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2004.09.001"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02200.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1994.tb00855.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/153.11.1089"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198307073090105"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-114-9-735"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.1.27"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200730100-00005"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7417.712"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp09X472629"},{"key":"e_1_2_8_28_1","volume-title":"Goodman and Gilman's The Pharmacological Basis of Therapeutics","author":"Brunton LC","year":"2006"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar146"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181dbebe3"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/154.9.854"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/11.6.954"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.12.1383"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01279.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1159\/000090321"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2008.05411.x"},{"issue":"3","key":"e_1_2_8_37_1","first-page":"iii23","article-title":"Underutilization of preventive strategies in patients receiving NSAIDs","volume":"42","author":"Sturkenboom MCJM","year":"2003","journal-title":"Rheumatology"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem375"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990802632915"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00839.x"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.03259.x"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02454.x"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpds.2350","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpds.2350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.2350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T10:59:50Z","timestamp":1696935590000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.2350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,25]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["10.1002\/pds.2350"],"URL":"https:\/\/doi.org\/10.1002\/pds.2350","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,25]]}}}