A new study has found a correlation between prolonged use of proton pump inhibitors and risk of early death, according to the Chicago Tribune.
Proton pump inhibitors are a type of medication used most often to treat heartburn, but also to help relieve symptoms of acid reflux and stomach ulcers. They work by reducing the amount of stomach acid produced by stomach glands.
The study, conducted by Dr. Ziyad Al-Aly, found that in people taking PPIs for a year or more, the risk of premature death increased by 51 percent. For people taking the drug for six months to a year the risk increased by 31 percent, and for three to six months of use the risk increased by 17 percent.
Short term use of up to 90 days did not affect death risk as found in the study.
Although it is unknown why PPIs may increase the risk of early death, Al-Aly told the Chicago Tribune that is it possible the drugs cause cellular or genetic damage.
Al-Aly also looked at the medical records of about 276,000 people who used PPIs against that of about 73,000 people who used H2 blockers, another class of heartburn medication, as reported by the Chicago Tribune.
The results showed that, overall, the risk of premature death is increased by 25 percent in PPI users as compared to H2 blockers users. This amounts to one extra death (that would not have occurred otherwise) for every 500 people taking PPIs for one year.
The study could not prove a direct cause-and-effect relationship between the drug and increased risk, but Al-Aly said it should add weight to the already existing concerns about the drugs’ safety.
“Why would prolonged use be associated with higher risk if there were no real relationship between exposure and untoward outcomes?” Al-Aly said to the Chicago Tribune.
PPIs are one of the most commonly used classes of drugs in the United States, but safety concerns have been growing in recent years. On top of Al-Aly’s new findings, PPIs have been linked to many serious complications including kidney disease, heart disease, pneumonia, bone fracture, and dementia.
Dr. Louis Cohen, an assistant professor of gastroenterology with the Icahn School of Medicine at Mount Sinai, points out that people taking PPIs tend to have many other health problems as well, which could influence their risk of death and therefore contribute to Al-Aly’s results. However, Cohen still believes Al-Aly’s results should be taken seriously.
“This finding is certainly cause for concern and something that should be considered as doctors continue to prescribe PPIs at a high rate and often fail to discontinue these drugs in a timely fashion,” Cohen told the Chicago Tribune.
Nevertheless, Al-Aly points out that for some patients, PPIs — even used long-term — are essential for dealing with medical issues.
“Proton pump inhibitors actually save lives,” Al-Aly said to the Chicago Tribune. “We don’t want to leave people with a scary message. If you need this drug and you’re under guidance of a doctor, you should continue to take your medication until otherwise advised.”
Unfortunately, it is common for people to take PPIs without guidance from a doctor.
Al-Aly noted that most recommended treatment regimens involving PPIs are relatively short. For example, to treat ulcers, PPIs only have to be taken for two to eight weeks.
However, some PPIs are available over-the-counter, and people are using them to manage conditions for months or even years.
“If people find themselves taking proton pump inhibitors for an extended period of time with no valid need for doing so, or for symptoms that can be managed in other ways, that’s when there’s far more risk than any potential benefit,” Al-Aly told the Chicago Tribune.
Cohen said that moving forward with this study in mind, “the challenge to physicians should remain to use medications judiciously and continue to assess the benefit of a medication to a patient over time.”
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