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Abstract

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French

BACKGROUND:

Assimilation of vitamin B₁₂ from dietary sources requires gastric acid. By decreasing acid production, the proton pump inhibitors (PPIs) and histamine₂ (H₂)-blockers may reduce vitamin B₁₂ absorption.

OBJECTIVE:

To determine whether chronic acid suppression therapy is associated with the initiation of vitamin B₁₂ supplementation, we conducted a retrospective case–control study using a state-wide Medicaid population.

METHODS:

Case patients were identified as those who initiated vitamin B₁₂ supplementation during the study period. Four control patients were age-and gender-matched to each case. Patients (n = 109 844) with a paid claim between September 27, 1995, and September 27, 1997, were eligible for inclusion. Chronic acid suppression therapy was defined as treatment with H₂-blockers or PPIs for ≥10 of the 12 months prior to the first vitamin B₁₂ injection. Comparisons were made between the case and control groups regarding exposure to chronic acid suppression therapy.

RESULTS:

One hundred twenty-five cases were matched to 500 controls. Twenty-three patients (18.4%) had been exposed to chronic acid suppression therapy compared with 55 (11.0%) of the control group (p = 0.025; OR 1.82; 95% CI 1.08 to 3.09).

CONCLUSIONS:

Initiation of vitamin B₁₂ supplementation was associated with chronic gastric acid suppression therapy.

Keywords

gastric acid suppression

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Increased Vitamin B 12 Requirement Associated with Chronic Acid Suppression Therapy