Medication

Prilosec and Similar Meds Linked to Increased Risk of Death

Posted onAuthorSoren Jameson

PROTON PUMP INHIBITORS AND EARLY DEATH

Proton Pump Inhibitors (PPIs) are used for the treatment of frequent heart burn and acid reflux. They are prescribed worldwide and are available as over the counter drugs with brand names like Prevacid, Prilosec and Nexium etc. PPIs are the most commonly prescribed class of drug, with prescriptions for Nexium alone reaching 15 million/month .

These drugs are often a critical medical treatment. If left untreated, chronic heartburn and acid reflux can lead to serious medical consequences, such as ulcers, intestinal bleeding, Barrets esophagus and even esophageal cancer.2

However, prolonged used of PPIs have been linked to a variety of health conditions, including chronic kidney disease, increased risk of fractures and increased risk of developing serious infections.3,4,5

A recent study carried at Washington University School of Medicine in St. Louis found that prolonged use of PPIs is linked to an increased risk of death.

Prilosec vs. Zantac

The researchers examined medical records of patients who were using PPIs, comparing them to patients under treatment with the class of drugs known as H2 blockers. The sample size was large, with approximately 350,000 records being examined. This researched was published in the peer review journal BMJ on July 2017.1

H2 blockers have a similar purpose to PPIs in that they are used decrease stomach acid production. While PPIs stop acid pumps from producing stomach acid, H2 blockers block the histamine receptors in acid-producing cells in the stomach. H2 blockers are sold under names like Zantac and Pepsid AC.

Study Results

It was found that PPI users had a 25% increased in the risk of death compared to the H2 group. The researchers calculated that for every 500 people who are on PPIs for over a year, one extra death would occur with could have been avoided. Though cause of death was not a facctor of analysis in this study, it’s possible that the these deaths might be attributed to some of the known risks of PPI use, such as kidney damage.

Furthermore the risk increased steadily as the period of PPI use increased. When compared with 30 days use, there was no significant difference in the risk of death for PPI users nor H2 blocker users. However, the risk rose substantially in PPI users with long-term use.

Research Conclusions

The researchers concluded that there is a substantial increase in the risk of death among people who use PPIs, and that the risk increases with prolonged use.

The study had certain limitations, however. A notable one is that the cause of death in their patients was not taken into consideration. Further, the population was mostly Caucasian males, which limits the generalizablility of the study. Finally, the study examined a period of 5 years; perhaps if it examined a longer period of time, results may not have been so unfavorable for the PPI users.

Though this study sheds new light on the consequences of PPI use, medical professionals are calling for caution against sweeping generalizations. PPIs have proven to be highly successful in treating various gastrointestinal diseases, and the level of risk shown in this study must be considered in light of this.2

That said, individuals are advised to limit over-the-counter use of PPIs to a relatively short period of time — the FDA has approved over-the-counter use of these drugs for short-term use only. Before continuing them for a longer period of time, it is advisable to check with your doctor. Using PPIs for heartburn and acid reflux indefinitely does not appear to be an ideal solution, and is a definitely a protocol that should be monitored by your doctor..

 

Referenced Works:

  1. Xie Y, Bowe B, Li T, Xian H, Yan Y, Al-Aly Z. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ open. 2017 Jun 1;7(6):e015735.
  2. Nathad DP, Roxaww S, Yunkyung L. Safety of Long Term Usage of PPIs with focus on bone fracture Risks, University of Texas, 2012.
  3. Arora P, Gupta A, Golzy M, Patel N, Carter RL, Jalal K, Lohr JW. Proton pump inhibitors are associated with increased risk of development of chronic kidney disease. BMC nephrology. 2016 Aug 3;17(1):112.
  4. Khalili H, Huang ES, Jacobson BC, Camargo CA, Feskanich D, Chan AT. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. Bmj. 2012 Jan 31;344:e372.
  5. Linsky A, Gupta K, Lawler EV, Fonda JR, Hermos JA. Proton pump inhibitors and risk for recurrent Clostridium difficile infection. Archives of internal medicine. 2010 May 10;170(9):772-8.