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Proton Pump Inhibitor Use and Increased Risk of Death

AntiacidProton Pump Inhibitor (PPI) are widely used by millions of people for indications and durations that were never tested or approved, and are available via prescription or as over the counter (OTC) in several countries including the United States. They are often overprescribed, rarely deprescribed, and frequently started inappropriately during a hospital stay. Their use is often extended for log-term duration without appropriate medical indications. Studies estimate between 53% and 69% of PPI prescriptions are for inappropriate indications. While PPIs are generally perceived as a safe class of therapeutics, PPI use is associated with a number of adverse health outcomes. They include acute interstitial nephritis, chronic kidney disease and progression to end stage renal disease, a rare but potentially fatal risk of hypomagnesemia, increased risk of incident and recurrent Clostridium difficile infections, and even a higher risk of incident dementia. In this large primary cohort of new users of acid suppression therapy followed for a median of 5.71 years, researchers show a significant association between PPI use and risk of all-cause mortality. Risk was increased among those with no documented indication for PPI use and with prolonged duration of use.

 

Xie Y, Bowe B, Li T, et al. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ Open 2017; e015735. Doi:10.1136/bmjopen-2016-015735

 

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