FDA Denies Petition for PPI Pneumonia Warning

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FDA has denied a 6/2020 Alliance for Natural Health citizen petition that urged the agency to require all makers of proton pump inhibitors (PPIs) to expand the existing label Warnings to include information about an increased risk of pneumonia. The group’s petition said “the causes of PPI-associated pneumonia are believed to be multifactorial, but stem from compromising the stomach’s ‘acid mantle,’ which protects against pathogenic bacteria.”

In denying the petition, FDA said that while several observational studies showed statistically significant association between PPIs and pneumonia, “we did not find reasonable evidence of a causal association to warrant the labeling changes requested in the petition.”

FDA further said that while available literature does show that PPIs may contribute to moderate inhibition of lysosomal enzyme activities, there still is “insufficient evidence of systematic immunosuppression by PPIs to support the argument set forth in the petition. Our review found no convincing evidence that moderate inhibition of lysosomal enzyme activities or other changes to the gastric environment such as changes to the gastrointestinal microbiota have a role in causing pneumonia.”

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