Clinical Implications of Emerging Data on the Safety of Proton Pump Inhibitors

  title={Clinical Implications of Emerging Data on the Safety of Proton Pump Inhibitors},
  author={Felice H. Schnoll-Sussman and Philip O. Katz},
  journal={Current Treatment Options in Gastroenterology},
Opinion statementProton pump inhibitors (PPI) are among the safest class of drugs used by all care providers, including gastroenterologists. They are the mainstay in treatment of acid-related disease, in particular, gastroesophageal reflux disease. Without them, many patients would experience a major decrement in their quality of life. However, no drug is without side effects or adverse events. In the past decade, numerous reports, principally case control studies and meta-analyses, have raised… 

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Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis.

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There is an association between acid suppression and an increased risk of enteric infection and further prospective studies on patients taking long-term acid suppression are needed to establish whether this association is causal.

Unexpected Effect of Proton Pump Inhibitors: Elevation of the Cardiovascular Risk Factor Asymmetric Dimethylarginine

This work presents a plausible biological mechanism to explain the association of PPIs with increased major adverse cardiovascular events in patients with unstable coronary syndromes and finds that PPIs elevate plasma ADMA levels and reduce nitric oxide levels and endothelium-dependent vasodilation in a murine model and ex vivo human tissues.

Proton Pump Inhibitors and Risk of Fracture: A Systematic Review and Meta-Analysis of Observational Studies

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The association of PPI exposure with risk for MI in the general population supports the pre-clinical findings that PPIs may adversely impact vascular function, and provides an example of how a combination of experimental and data-mining approaches can be applied to prioritize drug safety signals for further investigation.

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The results of the meta-analysis suggest that PPIs are a marker of increased cardiovascular risk in patients taking clopidogrel, rather than a direct cause of worse outcomes, and PPIs have the potential to decrease gastrointestinal bleeding in clopIDogrel users.