Does PPI Use Increase Mortality Risk?
The use of proton-pump-inhibitors (PPIs) is associated with increased mortality risk, according to the results of a recent study.
The researchers conducted a longitudinal observational cohort study involving a primary cohort of 349,312 new PPI or histamine H2 receptor antagonist (H2 blockers) users and additional cohorts including PPI vs no PPI (n= 3,288,092) and PPI vs no PPI and no H2 blockers (n-2,887,030).
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Over a median follow-up of 5.71 years, PPI use was associated with higher mortality risk than H2 blockers (hazard ratio [HR] 1.25 to 1.28). The increased risk was maintained in analyses adjusted for high-dimensional propensity score (HR 1.16 to 1.18) in 2-stage residual inclusion estimation (HR 1.21 to 1.26), and in 1:1 time-dependent propensity score-matched cohort (HR 1.34 to 1.39). The risk was increased among patients without gastrointestinal conditions (PPI vs H2 blockers [HR 1.24 to 1.27], PPI use vs no PPI [HR 1.19 to 1.20], PPI use vs no PPI and no H2 [HR 1.22 to 1.23].
“The results suggest excess risk of death among PPI users; risk is also increased among those without gastrointestinal conditions and with prolonged duration of use. Limiting PPI use and duration to instances where it is medically indicated may be warranted,” the researchers concluded.
—Michael Potts
Reference:
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 [published online July 4, 2017]. BMJ Open. doi: 10.1136/bmjopen-2016-015735.