More Bad News for PPI Users

Proton pump inhibitors are widely prescribed and are also available for sale over the counter without prescription in the US. Use of proton pump inhibitors (PPIs) are associated with increased risk of a number of adverse health outcomes including acute interstitial nephritis, chronic kidney disease and end-stage renal disease, incident dementia, increased risk of incident and recurrent Clostridium difficile infections, and increased risk of osteoporotic fractures, including hip and spine fractures. There is even in vitro evidence that suggests that PPI results
in inhibition of lysosomal acidification and impairment of proteostasis, leading to increased oxidative stress, endothelial dysfunction, telomere shortening and accelerated senescence in human endothelial cells. A longitudinal observational cohort study of new PPI or histamine H2 receptor antagonists, and additional cohorts including PPI versus no PPI and PPI versus no PPI and no H2 blockers was conducted using administrative data from the US Department of Veterans Affairs, with a median follow-up of 5.71 years. Study results suggest excess risk of death among PPI users. Risk is also increased among those without gastrointestinal conditions and with prolonged duration of use. Among new PPI users, there was a graded association between the duration of exposure and the risk of death. Clearly, limiting PPI use and duration of PPI use is warranted.

Yan Xie, Benjamin Bowe, et al. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. http://dx.doi.
org/10.1136/bmjopen-2016-015735