Another danger added to PPIs risk list, possible association with gastric cancer

PPI proton pump inhibitor Another danger added to PPIs risk list, possible association with gastric cancerA recent study has shown that prolonged PPI use is associated with increased risk of fundic gland polyps, and the study authors found a possible association with gastric cancer.

Acid reducing proton pump inhibitors, or PPIs, such as Prevacid, Nexium and Prilosec, prescribed to more than 15 million Americans in just a single year and available over-the-counter to countless more, seem to be constantly connected with new troubling risks.

They are already under fire for links to kidney disease and kidney failure. The manufacturers of these drugs are being sued by many patients with serious kidney injuries who allege “negligence, design defect, failure to warn, fraudulent concealment, warranty claims and loss of consortium” as the cause of action against defendants.

In addition to kidney injuries, WebMD lists previously established risks saying, “The drugs already carry warnings for several known risks, including C. difficile infections, which can cause chronic diarrhea; pneumonia; low magnesium levels, which can cause muscle spasms; heart palpitations and convulsions; and fractures of the hip, wrist, or spine. Fracture risks are generally highest in people who’ve taken high doses of the drugs for more than one year.”

Other risks that have emerged more recently include a study in April that found PPI users had a significantly higher risk of developing dementia. In September, researchers found that PPI use was a risk factor for spontaneous bacterial peritonitis, an abdominal fluid buildup, and might increase risk for hepatic encephalopathy, which is a loss of brain function. They concluded that PPIs should be used with caution in those with liver damage. In November, researchers presented preliminary findings that PPIs may increase risk of ischemic stroke.

According to Healio Gastroenterology the newest study was a systematic review and meta-analysis of randomized controlled trials and observational studies published through July 2015. The researchers found that after 12 months, PPI use was associated with the occurrence of fundic gland polyps (FGPs), which are gastric polyps on the stomach’s inner lining. They observed that risk of FGPs seemed to increase with increasing duration of PPI use. They also noted an association between PPI use and gastric cancer, however the strength of the association was limited by the small number of studies available for analysis on that subject and other possible confounding variables.

“Case reports describing the occurrence of [fundic gland polyps (FGPs)] in chronic PPI users have steadily emerged over time. However, the association of FGPs with the use of PPIs currently remains a topic of debate and the link between FGPs and the risk of gastric cancer is still unclear,” said the study authors.

“Given the large number of patients receiving PPIs, more and higher quality studies are needed to confirm or repudiate any causal link between PPI use and gastric cancer. In addition, the potential link between PPI-related FGPs and gastric cancer should be studied in more detail.”

Healio Gastroenterology
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