Association of proton-pump inhibitor use with adverse health outcomes: A systematic umbrella review of meta-analyses of cohort studies and randomised controlled trials.

Published on Oct 31, 2021in British Journal of Clinical Pharmacology4.34
· DOI :10.1111/BCP.15103
Sajesh K. Veettil12
Estimated H-index: 12
(UofU: University of Utah),
Saranrat Sadoyu1
Estimated H-index: 1
+ 8 AuthorsNathorn Chaiyakunapruk37
Estimated H-index: 37
(UW: University of Wisconsin-Madison)
Sources
Abstract
AIMS: The aim was to perform an umbrella review to summarise the existing evidence on proton-pump inhibitor (PPI) use and adverse outcomes and to grade the certainty of evidence. METHODS: Electronic databases were searched up to July 2021 for meta-analyses of cohort studies and/or randomised controlled trials (RCTs). Summary effect sizes from a random-effects model, between-study heterogeneity, 95% prediction interval, small-study effect, excess significance and credibility ceilings were devised to classify the credibility of evidence from meta-analyses of cohort studies, whereas the GRADE approach was used for meta-analyses of RCTs. RESULTS: In meta-analyses of cohort studies, 52 of the 91 examined associations were statistically significant (P ≤ .05). Convincing evidence emerged from main analysis for the association between PPI use and risk of all-site fracture and chronic kidney disease in the elderly population. However, none of these associations remained supported by convincing evidence after sensitivity analyses. The use of PPI is also associated with an increased risk of mortality due to COVID-19 infection and other related adverse outcomes, but the quality of evidence was weak. In meta-analyses of RCTs, 38 of the 63 examined associations were statistically significant. However, no associations were supported by high or moderate-quality evidence. CONCLUSION: This study's findings imply that most putative adverse outcomes associated with PPI use may not be supported by high-quality evidence and are likely to have been affected by underlying confounding factors. Future research is needed to confirm the causal association between PPI use and risk of fracture and chronic kidney disease.
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References95
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#7Guangji Wang (CPU: China Pharmaceutical University)H-Index: 62
The article by Lee et al 1 showed that the current use of proton pump inhibitors (PPIs) increased the risk of severe clinical outcomes of COVID-19 rather than the susceptibility to SARS-CoV-2 infection in a Korean nationwide cohort. Instead, a significant association between susceptibility to SARS-CoV-2 infection and current use of PPIs, either one time or two times a day, was found by another recent study2 based on US nationwide data. The conflicting results of these two large-scale observation...
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#1Elizabeth M SalvoH-Index: 1
#2Nicole C FerkoH-Index: 1
Last. Peter J. Kahrilas (NU: Northwestern University)H-Index: 124
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Background null Proton pump inhibitors (PPIs) are widely used to treat and prevent acid-related disorders. Despite high efficacy, PPI safety has been increasingly scrutinised. However, no comprehensive review summarising investigations of various adverse events is available. null Aims null To perform an umbrella review to comprehensively assess associations between adverse events and PPI use. null Methods null In accordance with PRISMA, an umbrella review of systematic reviews with meta-analyses...
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#2D Moher (U of O: University of Ottawa)H-Index: 22
The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and ...
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#1Faisal Kamal (UTHSC: University of Tennessee Health Science Center)H-Index: 8
#2Muhammad Ali Khan (UAB: University of Alabama at Birmingham)H-Index: 11
Last. Colin W. Howden (UTHSC: University of Tennessee Health Science Center)H-Index: 70
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#1Wen-Ce ShiH-Index: 2
#2Lu YanH-Index: 1
Last. Mengyue YuH-Index: 4
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BACKGROUND Pharmacokinetic and pharmacodynamic study showed a lower clopidogrel response when coprescribed with proton pump inhibitors (PPIs). Despite this, PPIs is necessary for patients treated with long term dual antiplatelet therapy (DAPT). Ethnic variance also played a different effect on clopidogrel response. Our study evaluated the effect of concomitant use of DAPT and PPIs and assessed whether ethnic variance exert different effect on clinical outcomes. METHODS We carefully searched EMBA...
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#1Sajesh K. Veettil (UofU: University of Utah)H-Index: 12
#2Tse Yee Wong (International Medical University)H-Index: 2
Last. Nathorn Chaiyakunapruk (UofU: University of Utah)H-Index: 37
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Importance Several meta-analyses have summarized evidence for the association between dietary factors and the incidence of colorectal cancer (CRC). However, to date, there has been little synthesis of the strength, precision, and quality of this evidence in aggregate. Objective To grade the evidence from published meta-analyses of prospective observational studies that assessed the association of dietary patterns, specific foods, food groups, beverages (including alcohol), macronutrients, and mi...
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#1Sara Aleraij (National Guard Health Affairs)H-Index: 1
#2Sultan Y. Al-Howti (National Guard Health Affairs)H-Index: 2
Last. Imad Abdulmajeed (National Guard Health Affairs)H-Index: 9
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Abstract Despite the fact that proton pump inhibitors (PPIs) are one of the most prescribed medications, several epidemiological studies have reported many adverse effects related to their long-term usage. Nevertheless, there were inconsistent findings in the literature with regard to PPI use and bone mineral density (BMD) change. The aim of this systematic review and meta-analysis is to evaluate the association between the use of PPIs and change in BMD. The PubMed/MEDLINE, EMBASE, Cochrane and ...
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#1Tianyi Ma (JLU: Jilin University)H-Index: 1
#2Meng Wu (JLU: Jilin University)H-Index: 1
Last. Lanlan Yang (JLU: Jilin University)H-Index: 1
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Purpose The increased risk of colorectal cancer (CRC) associated with long-term use of proton pump inhibitors (PPIs) has attracted considerable attention; however, the conclusions of studies evaluating this correlation are inconsistent or even controversial. Therefore, we conducted a systematic review and meta-analysis to determine the association of PPI use with the risk of CRC. Methods A systematic literature search was conducted in PubMed, EMBASE, and the Cochrane Central Register of Controll...
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#1Palna Mehta (RU: Rutgers University)H-Index: 1
#2Ronald Nahass (Robert Wood Johnson University Hospital)H-Index: 13
Last. Luigi Brunetti (RU: Rutgers University)H-Index: 19
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BACKGROUND: Studies have had conflicting results regarding the influence of acid suppression medications (ASM) during hospitalization on the recurrence of Clostridioides difficile infection (CDI). METHODS: A systematic review and meta-analysis investigating the association between recurrent CDI and ASM use in inpatients was performed. Relevant literature was identified using Medline, Google Scholar, and Web of Science. All human studies were considered regardless of when they were published. Cas...
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#1Maria Effenberger (Innsbruck Medical University)H-Index: 14
#2Felix Grabherr (Innsbruck Medical University)H-Index: 11
Last. Herbert Tilg (Innsbruck Medical University)H-Index: 100
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GI symptoms such as diarrhoea, nausea and vomiting are frequent coronavirus disease (COVID-19) symptoms and affect up to 28% of patients.1–5 The pathophysiology of COVID-19-associated GI symptoms is currently unclear. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-RNA was detected in the faeces in ~50% of patients with COVID-193 5 6; SARS-CoV-2 viral particles were observed by electron microscopy in stool samples from two patients without diarrhoea2; and one study reported SARS-CoV...
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