Acid Reflux (GERD) Drugs (PPI) Increase Risk Of Early Death

haidut

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I posted a few studies in the past in regard to the PPI class fo drugs causing kidney failure, stroke, steroid synthesis inhibition and even cancer. Now this study links these drugs to an increased risk of premature death. Keeping in mind the PPI class of drugs are probably the most widely prescribed medication in the world, no wonder mortality in people younger than 50 has been increasing steadily since the 1990s.
Notably, the study also found that the older GERD drugs (H2 antagonists) were NOT linked to increased risk of death.
Hey @aguilaroja I think you'll find this new study interesting.

Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans | BMJ Open
Heartburn drugs tied to increased risk of early death, study says - CNN.com

"...At prescription strength, proton-pump inhibitors are associated with a potential 25% increased risk of early death from any cause, suggests new research published Monday in the British Medical Journal Open. This study did not examine over-the-counter proton-pump inhibitors or particular brands of prescription-strength drugs. The drugs, known as PPIs, suppress excess acid in the stomach. Generally, prescription formulas are taken by patients with severe conditions for long periods, while lower-dose over-the-counter formulas are approved for only short-term use by the US Food and Drug Administration."
 

aguilaroja

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Thanks @haidut for raising this. Biostatisticians find mortality numbers easier to quantify, since the “endpoint” is clear, and there is less uncertainty about reporting percentages, as compared with morbidity/side effect reporting.

I am not aware of a rule of thumb about mortality to morbidity “ratios” from a given source. It seems likely that for every death, there would be at least ten times more other significant side effects, here relating to PPI’s.

Since PPI’s (Nexium, Prilosec, Prevacid, Aciphex, Protonix) are dispensed both by prescription and over-the-counter in many places. AFAIK combined Rx & OTC total about quantity of use is not often tabulated. It is easily tens of millions of people just in North America, by sales figures. That’s a pretty big number of possible effects.

Or, in the words of the Xie & Al-Aly study: “The consistency of study findings in our report and the growing body of evidence in the literature showing a host of adverse events associated with PPI use are compelling, and because of the high prevalence of PPI use, it may have public health implications.”

A British journal provided the forum for U.S-based research.

http://bmjopen.bmj.com/content/bmjopen/7/6/e015735/F1.large.jpg
 

mr_mercer

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I am aware of four infants in my extended family right now on proton pump inhibitors to deal with inability to keep food down and gain weight. Formula or breast fed appears irrelevant in the data set I have. They were spitting everything up and staying underweight. It seems like some weird epidemic to me.

EDIT: what does one tell the mother of a young underweight child who spits up constantly? Toss some niacinamide in the bottle? Rub some on the skin? No way they'd take that advice.

I worry that these kids are being permanently stunted in height by the drugs. I've seen this play out twice before and the kids so far seem to remain permanently under sized.
 
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haidut

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I am aware of four infants in my extended family right now on proton pump inhibitors to deal with inability to keep food down and gain weight. Formula or breast fed appears irrelevant in the data set I have. They were spitting everything up and staying underweight. It seems like some weird epidemic to me.

EDIT: what does one tell the mother of a young underweight child who spits up constantly? Toss some niacinamide in the bottle? Rub some on the skin? No way they'd take that advice.

I worry that these kids are being permanently stunted in height by the drugs. I've seen this play out twice before and the kids so far seem to remain permanently under sized.

They can use the older H2 antagonists who have not been shown to increase mortality of cause long term issues. And those are OTC too, with famotidine being perhaps the least risky. I would ask a doctor first but there is no excuse to give PPI to a toddler/baby.
 
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