Recent laboratory findings have indicated that the proton pump inhibitor (PPI) lansoprazole is highly active against Mycobacterium tuberculosis, but there has been no clinical research into this effect.
In a paper in PLoS Medicine (21 November 2017), researchers used data from the UK Clinical Practice Research Datalink to compare the incidence of tuberculosis in people taking lansoprazole with that among those taking omeprazole or pantoprazole, two PPIs that have no known activity against M. tuberculosis
The researchers found a significantly lower incidence of tuberculosis in lansoprazole users (10 cases per 100,000 person years) than in omeprazole or pantoprazole users (15.3 cases per 100,000 person years).
But it was not possible to determine from the results whether the association demonstrated was against tuberculosis resulting from recent infection or from reactivation of latent infection.
The team said, given the problem of antimicrobial resistance and adverse events with existing tuberculosis treatments, further exploration of lansoprazole is warranted, ideally through randomised trials.