Drug Consumption and the Risk of Microscopic Colitis

Fernández-Bañares, Fernando; Esteve, Maria; Espinós, Jorge C.; Rosinach, Mercé; Forné, Montserrat; Salas, Antonio; Viver, Josep Maria
February 2007
American Journal of Gastroenterology;Feb2007, Vol. 102 Issue 2, p324
Academic Journal
BACKGROUND: Microscopic colitis is a rare disease of unknown etiology. It has been described that some drugs could cause or worsen the disease; however, the scientific evidence is limited. AIM: To investigate the possible association of chronic drug consumption with microscopic colitis. METHODS: This was a case–control study in which groups of cases were: Group 1–39 patients with collagenous colitis; Group 2–39 patients with lymphocytic colitis; and Group 3–52 patients with chronic watery diarrhea of functional characteristics. 103 subjects formed the control group. At diagnosis, a drug consumption history of at least 2-wk duration was registered. An age- and sex-adjusted logistic regression analysis was used, and the odds ratio (OR, 95% CI) was calculated. RESULTS: Drug consumption was more frequent in lymphocytic colitis than in the control group (92.3% vs 76.3%, P < 0.05). The mean daily number of drugs by person was also higher in lymphocytic colitis (3.79 ± 0.44 vs 2.13 ± 0.22, P= 0.04). The following associations as compared with the control group were observed: Group 1—Consumption of NSAIDs (46.2% vs 23%, OR 2.9, 1.3–6.4), selective serotonin reuptake inhibitors (SSRIs) (18% vs 1%, OR 21, 2.5–177), specifically, sertraline (15.4% vs 0%, P < 0.0005); Group 2—SSRIs (28% vs 1%, OR 37.7, 4.7–304), beta-blockers (13 vs 3%, OR 4.79, 1.04–20), statins (13% vs 3%, OR 4.6, 1.04–20), biphosphonates (8% vs 0%, P= 0.022); Group 3—SSRIs (15% vs 1%, OR 16.2, 2–135), statins (11.5% vs 3%, OR 5.4, 1.2–24). As compared with the chronic diarrhea group, a significant association with the usage of sertraline in LC ( P= 0.005) and a trend for NSAIDs in CC ( P= 0.057) were found. CONCLUSIONS: Drug consumption increases the risk of microscopic colitis. Some drugs might be trigger factors of colonic inflammation in predisposed hosts, and others might only worsen self-evolving microscopic colitis.


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