Adverse effects of proton pump inhibitor drugs: clues and conclusions.

Abstract:

PURPOSE OF REVIEW:To review evidence relating to the strength of associations that have appeared in largely observational studies, between high-dose or long-term use of proton pump inhibitor drugs and certain possibly attributable side-effects, which emerge from studies confounded by other variables. In retrospective studies not designed to assess safety, evidence of causality is generally lacking. RECENT FINDINGS:The associations of fractures of hip, wrist, forearm and other sites appear weak and only slightly higher than the risks in control populations matched for age. They may increase with drug exposure, but probably do so only in individuals in whom other risk factors are also operational (smoking, alcohol, poor nutrition, steroids, etc.). The risks of Clostridium difficile colitis, other enteric infections, small bowel bacterial overgrowth and possibly spontaneous bacterial peritonitis also appear increased. Impaired gastric secretion may adversely affect the absorption of various nutrients, but their clinical impact is ill defined. Potentially more important are the consequences of hypergastrinemia, including rebound hypersecretion of acid, and possible development of various cancers, including carcinoid tumors. Effects of other drugs, including clopidogrel, on metabolism are reviewed, but clouded by uncertainties. SUMMARY:The safety of long-term PPI administration needs serious prospective study.

authors

McCarthy DM

doi

10.1097/MOG.0b013e32833ea9d9

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

624-31

issue

6

eissn

0267-1379

issn

1531-7056

journal_volume

26

pub_type

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