Abstract
Objective This study aimed to investigate the association between proton pump inhibitor (PPI) use and the incidence of intestinal Behçet's disease (BD) in patients with BD.
Methods A retrospective cohort study was conducted at the University of Tokyo Hospital, including BD patients diagnosed between April 2005 and November 2023. Cox models and Kaplan-Meier analyses were utilized to evaluate hazard ratios (HRs) and cumulative incidence of intestinal BD, respectively. Secondary analyses were performed to assess the duration and dose-response relationship of PPI use.
Results Among 194 BD patients, 25.3% developed intestinal BD during a mean followup of 12 years. PPI users exhibited a significantly higher incidence of intestinal BD compared to non-users (adjusted HR 2.48, 95% CI 1.38–4.47, P = 0.0024), with a confirmed duration/dose-dependent relationship. The cumulative incidence of intestinal BD was markedly elevated in PPI users (Log rank P < 0.001). The result was similar to that in the Propensity score-matched cohort.
Conclusion The study demonstrates a significant association between PPI use and increased incidence of intestinal BD in BD patients. Caution in prescribing PPIs for BD patients is warranted due to the potential risk of severe complications associated with intestinal BD.
