Researchers encourage limiting use of proton pump inhibitors

PPI proton pump inhibitor Researchers encourage limiting use of proton pump inhibitorsIn two separate articles this month, The Nation has warned its readers about recent studies done on popular heartburn drugs. These drugs known as proton pump inhibitors, or PPIs, include drugs such as Prevacid, Nexium and Prilosec. They are commonly used, both prescribed by doctors and over-the-counter, to treat heartburn, acid reflux and ulcers.

“At one time, PPIs were thought to be safe, without major side effects. This study further questions the cardiovascular safety of these drugs.” said lead study author Dr. Thomas Sehested of the Danish Heart Foundation in Copenhagen, Denmark.

Dr. Sehested’s study, which, according to The Nation, was presented at the American Heart Association’s Scientific Sessions 2016, found that high-dose PPI use increased risk of ischemic stroke by 21 percent, with the PPI lansoprazole, which is the active ingredient in Prevacid, increasing the risk of ischemic stroke even more than the others, by 94 percent.

The researchers also tested competing acid reflux drugs H2 blockers, which include Pepcid, Tagamet and Zantac, but found no connection between these drugs and increased risk to ischemic stroke.

This study does not prove that PPIs cause ischemic strokes but the researchers say that the results suggest that patients and doctors should use caution when using and prescribing PPIs. More research needs to be done to better understand PPIs risks, especially considering how widely used they are.

“We know that from prior studies that a lot of individuals are using PPIs for a much longer time than indicated, which is especially true for elderly patients,” said Dr. Sehested.

The senior author of the other study The Nation recently reported on had similar concerns.

“A lot of patients start taking PPIs for a medical condition, and they continue much longer than necessary,” said Dr Ziyad Al-Aly, a nephrologist of the VA Saint Louis Health Care System in Missouri.

Dr. Al-Aly and his colleagues’ study is one of several that have linked PPIs to increased risk of kidney disease. Compared to those taking H2 blockers, PPI users were more likely to experience kidney decline, their risk of developing chronic kidney disease was increased by 28 percent, and they had a 96 percent higher risk of developing kidney failure. The researchers also found that the risk of developing kidney problems increased with the duration of PPI use. They concluded that the findings suggested that long-term use of PPIs may cause harm to the kidneys and should be avoided.

“The results emphasize the importance of limiting PPI use only when it is medically necessary, and also limiting the duration of use to the shortest duration possible,” said Dr. Al-Aly.

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