Some acid reflux drugs raise death risk 25%


Tuesday, 11 July, 2017

Some acid reflux drugs raise death risk 25%

A new study into proton pump inhibitors (PPIs) suggests users may face a heightened risk of death and that medical professionals should reconsider their use.

PPIs are used to curb excess stomach acid production. Given how widely available these drugs are, and the accumulating evidence pointing to potentially serious side effects, it may be time to restrict their use, suggests the research published in the online journal BMJ Open.

The researchers base their findings on national US data obtained from a network of integrated healthcare systems involving more than 6 million people whose health was tracked for an average of almost six years — until 2013 or death, whichever came first.

They carried out three comparative analyses: those taking PPIs with those taking another type of drug used to dampen down acid production called histamine H2 receptor antagonists or H2 blockers for short; users and non-users of PPIs; and users of PPIs with people taking neither PPIs nor H2 blockers.

Compared with H2 blocker use, PPI use was associated with a 25% heightened risk of death from all causes, a risk that increased the longer PPIs were taken.

The other analyses revealed a similar level of risk between users and non-users of PPIs and between those taking PPIs and those taking no acid-suppressant drugs.

The risk of death was also heightened among those who were taking PPIs despite having no appropriate medical indication for their use, such as ulcers, H. pylori infection, Barrett’s oesophagus (pre-cancerous changes to the food pipe) and gullet (oesophageal) cancer.

As this is an observational study, no firm conclusions can be drawn about cause and effect. Nor were the researchers able to obtain information on the causes of death.

Nevertheless, the researchers suggest that the consistency of their results and the growing body of evidence linking PPI use with a range of side effects is “compelling”.

They wrote: “Although our results should not deter prescription and use of PPIs where medically indicated, they may be used to encourage and promote pharmacovigilance [monitoring the side-effects of licensed drugs] and [they] emphasise the need to exercise judicious use of PPIs and limit use and duration of therapy to instances where there is a clear medical indication and where benefit outweighs potential risk.”

Image credit: ©stock.adobe.com/au/Adiano

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