A large observation study provides some bad publicity for proton pump inhibitors (PPI):
BMJ Open Access: Risk of death among users of Proton Pump Inhibitors: a longitudinal
observational cohort study of United States veterans (Y Xie et al BMJ Open
2017;7:e015735. doi:10.1136/bmjopen-2016-01573) Thanks to Ben Enav for this reference.
This study selected ~350,000 patients from a database which identified more than 1.7 million PPI users. These patients were ‘new’ PPI users.
Key finding: Over a median follow-up of 5.71 years, PPI use was associated with increased risk of death compared with H2 blockers use (HR 1.25, CI 1.23 to 1.28).
The authors note the limitations of this observational study; however, they suggest that the findings cannot be fully explained by residual confounders. They recommend limiting PPI use to “instances and durations where it is medically indicated.”
My take: As noted in a recent post (see below), some risks attributed to PPIs in observational studies do not pan out. Yet, PPI therapies need to be better-targeted to those who will truly benefit from them.
Related blog posts:
- Recent study did NOT find risk of dementia with PPIs
- Piling on PPIs -Now Concerns about Dementia
- Proton Pump Inhibitors Webinar
- More advice on Proton Pump Inhibitors
- The Prosecution Rests…PPIs on Trial
- PPIs Alter the Microbiome