Year 2023 / Volume 115 / Number 9
Editorial
Safe use of proton-pump inhibitors

475-479

DOI: 10.17235/reed.2023.9834/2023

Carlos Martín de Argila de Prados, Julia López Cardona, Federico Argüelles-Arias,

Abstract
Proton pump inhibitors (PPIs) are one of the most commonly prescribed drug groups in developed countries. Their approved indications include gastroesophageal reflux disease, peptic ulcer disease, and prophylaxis against NSAID-induced gastroenteropathy in specific scenarios. Since their introduction into clinical practice, their usage has significantly increased, leading to concerns about possible inappropriate prescribing, which can result in a higher risk of side effects and increased economic costs. Consequently, in recent years, literature linking PPIs to various adverse effects has emerged, with some supported by robust evidence, while others are based on lower-quality evidence, requiring cautious interpretation. Among the adverse effects of PPIs, significant ones include an increased risk of fragility fractures, deficiencies in certain micronutrients such as vitamin B12 and magnesium, a higher incidence of enteric infections, especially Clostridioides difficile, complications in cirrhotic patients, and pharmacological interactions with other medications. In clinical practice, it is essential to periodically evaluate the rationale for prescribing these drugs and consider discontinuing them if there is no appropriate indication. Despite PPIs being generally safe medications, it is crucial to be aware of their potential adverse effects and appropriate indications to ensure their proper use.
Share Button
New comment
Comments

30/10/2023 22:05:51
Que problemas puede tener en pacientes con hígado graso


References
1. Aguilera Castro L, Martín-de-Argila C, Albillos A. Practical considerations in the management of proton-pump inhibitors. Rev Esp Enferm Dig. 2016;108:145–53.
2. Savarino V, Dulbecco P, de Bortoli N, et al. The appropriate use of proton pump inhibitors (PPIs): Need for a reappraisal. Eur J Intern Med. 2017;37:19–24.
3. de-la-Coba C, Argüelles-Arias F, Martín-De-Argila C, et al. Proton-pump inhibitors adverse effects: A review of the evidence and position statement by the Sociedad Española de Patología Digestiva. Rev Esp Enfermedades Dig. 2016;108:207–24.
4. Targownik LE, Fisher DA, Saini SD. AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review. Gastroenterology. 2022;162:1334–42.
5. Datos des Ministerio Nacional de Sanidad de España publicados anualmente sobre consumo de medicamentos en recetas médicas dispensadas en oficinas de farmacia con cargo al Sistema Nacional de Salud en el 2022. Available from: https://www.sanidad.gob.es/profesionales/farmacia/ConsumoRecetasATC/ATC_2022.htm. [visitado en 20/4/23].
6. Salvo EM, Ferko NC, Cash SB, et al. Umbrella review of 42 systematic reviews with meta-analyses: the safety of proton pump inhibitors. Aliment Pharmacol Ther. 2021;54:129–43.
7. Corley DA. Safety and Complications of Long-Term Proton Pump Inhibitor Therapy: Getting Closer to the Truth. Gastroenterology. 2019;157:604–7.
8. Lo CH, Ni P, Yan Y, et al. Association of Proton Pump Inhibitor Use With All-Cause and Cause-Specific Mortality. Gastroenterology. 2022;852–61.
9. Moayyedi P, Eikelboom JW, Bosch J, et al. Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin. Gastroenterology. 2019;157:682-691.e2.
10. McDonald EG, Milligan J, Frenette C, et al. Continuous proton pump inhibitor therapy and the associated risk of recurrent clostridium difficile infection. JAMA Intern Med. 2015;175:784–91.
11. Johnstone J, Nerenberg K, Loeb M. Meta-analysis: Proton pump inhibitor use and the risk of community-acquired pneumonia. Aliment Pharmacol Ther. 2010;31:1165–77.
12. Attwood SE, Ell C, Galmiche JP, et al. Long-term safety of proton pump inhibitor therapy assessed under controlled, randomised clinical trial conditions: Data from the SOPRAN and LOTUS studies. Aliment Pharmacol Ther. 2015;41:1162–74.
13. Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Riesgo de hipomagnesemia asociado a los medicamentos inhibidores de la bomba de protones (IBP). Ref. MUH (FV), 27/2011. Accesible en: http://www.aemps.gob.es/informa/notasInformativas/medica. [visitado en 20/4/23].
14. Gommers LMM, Hoenderop JGJ, de Baaij JHF. Mechanisms of proton pump inhibitor-induced hypomagnesemia. Acta Physiol. 2022;235:1–12.
15. Lespessailles E, Toumi H. Proton Pump Inhibitors and Bone Health: An Update Narrative Review. Int J Mol Sci. 2022;23.
16. Poly TN, Islam MM, Yang HC, et al. Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies. Osteoporos Int. 2019;30:103–14.
17. Mahmud N, Serper M, Taddei TH, et al. The Association Between Proton Pump Inhibitor Exposure and Key Liver-Related Outcomes in Patients With Cirrhosis: A Veterans Affairs Cohort Study. Gastroenterology. 2022;163:257-269.e6.
18. Xin-Xing T, Long-Bao Y, Zhong-Cao W, et al. Association of proton pump inhibitors with risk of hepatic encephalopathy in advanced liver disease: A meta-analysis. World J Gastroenterol. 2019;25:2683–98.
19. Chinzon D, Domingues G, Tosetto N, et al. Safety of long-term proton pump inhibitors: facts and myths. Arq Gastroenterol. 2022;59:219–25.
20. China L, Tittanegro T, Crocombe D, et al. Investigating potential confounding by indication when considering the association between proton pump inhibitor use, infection, hepatic encephalopathy and mortality in hospitalised decompensated cirrhosis: a post-hoc analysis of the ATTIRE trial. eClinicalMedicine. 2023;58:101924.
21. Han CT, Islam MM, Poly TNet al. A Meta-Analysis of Proton Pump Inhibitor Use and the Risk of Acute Kidney Injury: Geographical Differences and Associated Factors. J Clin Med. 2023;12.
22. Ben Ghezala I, Luu M, Bardou M. An update on drug–drug interactions associated with proton pump inhibitors. Expert Opin Drug Metab Toxicol. 2022;18:337–46.
23. Bhatt DL, Cryer BL, Contant CF, et al. Clopidogrel with or without Omeprazole in Coronary Artery Disease. N Engl J Med. 2010;363:1909–17.
24. Desai M, Nutalapati V, Srinivasan S, et al. Proton pump inhibitors do not increase the risk of dementia: A systematic review and meta-analysis of prospective studies. Dis Esophagus. 2020;33:1–9.
25. Schubert ML. Proton pump inhibitors: misconceptions and proper prescribing practice. Curr Opin Gastroenterol. 2020;36:493–500.
Related articles
Citation tools
Martín de Argila de Prados C, López Cardona J, Argüelles-Arias F. Safe use of proton-pump inhibitors. 9834/2023


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 5331 visits.
This article has been downloaded 1561 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 10/07/2023

Accepted: 12/07/2023

Online First: 31/07/2023

Published: 06/09/2023

Article Online First time: 21 days

Article editing time: 58 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology