PPIs Tag

28 Jan

Posted at 13:59h in Author Interviews, Diabetes, JCEM, Pharmacology
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle, MedicalResearch.com Interview with: Tingting Geng PhD Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and Safety Ministry of Education Key Lab of Environment and Health State Key Laboratory of Environment Health (Incubating) School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan, China MedicalResearch.com: What is the background for this study? Response: Previous studies have suggested that proton pump inhibitors (PPIs) may lead to an increase in cardiovascular events due to the drug-drug interactions between PPIs and clopidogrel and gut microbiota dysbiosis. Patients with Type 2 Diabetes (T2D) are at more than three times higher prevalence of using PPIs, and two- to fourfold higher risk of developing cardiovascular complications and premature death than general populations. However, evidence regarding the influence of PPI use on subsequent risks of cardiovascular disease and mortality among patients with T2D is scarce. We conducted a prospective study using the UK Biobank study to examine the association of PPI use with risks of coronary artery disease, myocardial infarction, heart failure, stroke and mortality among patients with T2D. Using multivariable-adjusted Cox regression models and a propensity score-matched cohort, researchers found robust results that PPIs use was associated with a higher risk of coronary artery disease (adjusted HR=1.27), myocardial infarction (adjusted HR=1.34), heart failure (adjusted HR=1.35), and mortality (adjusted HR=1.30).

08 Feb

Posted at 16:45h in Asthma, Author Interviews, JAMA, Karolinski Institute, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_56576" align="alignleft" width="150"]Yun-Han Wang PhD student, Karolinska Institute Yun-Han Wang[/caption] Yun-Han Wang MSc PhD student, Karolinska Institute MedicalResearch.com: What is the background for this study? Response: The use of proton pump inhibitors (PPIs) in children has increased substantially in recent years, concurrently with emerging concerns that these drugs may increase the risk of asthma. Whether PPI use in the broad pediatric population is associated with increased risk of asthma is not known. 

17 Mar

Posted at 16:34h in Author Interviews, Gastrointestinal Disease, JAMA, Orthopedics, Pediatrics
[caption id="attachment_53500" align="alignleft" width="150"]Yun-Han Wang PhD Student Karolinska Institute Yun-Han Wang[/caption] MedicalResearch.com Interview with: Yun-Han Wang, PhD Student Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Proton pump inhibitor (PPI) use has been linked to increased risk of fracture in adults. Despite an increasing trend in prescription of PPIs in children, there is scarce evidence regarding this safety concern in pediatric patients.

25 Feb

Posted at 11:46h in Author Interviews, Gastrointestinal Disease, JAMA, Microbiome
MedicalResearch.com Interview with: Drs. R.P.J. Willems  |  Arts-onderzoeker Medische Microbiologie en Infectiepreventie Amsterdam MedicalResearch.com: What is the background for this study? Does your study refer to both PPIs and H2-blockers?  Response: There is mixed evidence on the associated risk of colonization and infection with multidrug-resistant microorganisms with acid suppressive therapy. We therefore aimed to investigate current literature in order to determine whether acid suppressants facilitate intestinal colonization with multidrug-resistant microorganisms. We included studies on PPIs, H2 blockers and antacids.

20 Jan

Posted at 19:35h in Author Interviews, Breast Cancer, Cancer Research, Cognitive Issues
MedicalResearch.com Interview with: [caption id="attachment_52873" align="alignleft" width="200"]Annelise Madison Lead author of the study Graduate Student in Clinical Psychology Ohio State Annelise Madison[/caption] Annelise Madison Lead author of the study Graduate Student in Clinical Psychology Ohio State MedicalResearch.com: What is the background for this study? Response: Recently, there have been some reports of cognitive problems among those using proton pump inhibitors (PPIs). Some breast cancer survivors use PPIs during and after treatment to manage gastrointestinal side effects of cancer treatment or to prevent damage to the gut lining. We were interested in whether PPI use among breast cancer survivors related to cognitive problems. We conducted secondary analyses on data from three studies with breast cancer survivors. We found that breast cancer survivors taking PPIs reported cognitive problems that were between 20-29% worse than those reported by non-users.

31 May

Posted at 00:41h in Author Interviews, Gastrointestinal Disease, Heart Disease, Pharmacology
MedicalResearch.com Interview with: [caption id="attachment_49463" align="alignleft" width="145"]Ziyad Al-Aly, MD, FASNAssistant Professor of MedicineDirector of the Clinical Epidemiology CenterChief of Research and EducationDepartment of Veterans Affairs Health Care SystemSaint Louis Dr. Ziyad Al-Aly[/caption] Ziyad Al-Aly, MD, FASN Assistant Professor of Medicine Director of the Clinical Epidemiology Center Chief of Research and Education Department of Veterans Affairs Health Care System Saint Louis  MedicalResearch.com: What is the background for this study?   Response: In 2017, we published a paper showing increased risk of death associated with Proton-pump inhibitors (PPI) use. Following the publication of that 2017 paper, several key stakeholders including patients, doctors, research scientists, medical media folks, mainstream media folks, and others asked us: what do these people die from? Did you study causes of death attributable to PPI use? In the study published today, we developed a causal inference framework to answer this question.

28 May

Posted at 23:46h in Author Interviews, Baylor University Medical Center Dallas, Gastrointestinal Disease
MedicalResearch.com Interview with: [caption id="attachment_49399" align="alignleft" width="115"]Dr. Rhonda Souza, MDBaylor University Medical CenterCenter for Esophageal ResearchDallas, TX 75246 Dr. Souza[/caption] Dr. Rhonda Souza, MD Baylor University Medical Center Center for Esophageal Research Dallas, TX 75246  MedicalResearch.com: What is the background for this study?   Response: Eosinophilic esophagitis (EoE) is a modern disorder of the esophagus caused by an allergy to certain foods. EoE causes esophageal symptoms like difficulty swallowing and heartburn and is diagnosed when biopsies of the esophagus taken during endoscopy show numerous eosinophils, which are a type of inflammatory blood cell.  There are few established treatments for EoE. One such treatment is a diet that eliminates the offending food allergens, and another is to use steroids to reduce the number of eosinophils in the esophagus. However, the most common treatment for adults with eosinophilic esophagitis is to use proton pump inhibitors (PPIs), which block the proton pumps in stomach cells that make acid.  In earlier studies, we found that PPIs also can block proton pumps in esophageal cells.  Those proton pumps are activated by chemicals that the body produces in response to allergens including interleukin (IL)-13 or IL-4.  Il-13 and IL-4, which cause the esophagus to produce eotaxin-3, a molecule that attracts eosinophils. What remained unknown, however, was the mechanism whereby these interleukins activate proton pumps in the EoE esophagus. In our present study, we explored whether IL-4 works by increasing calcium levels in esophageal cells from EoE patients.

07 Nov

Posted at 18:11h in Author Interviews, BMJ, Cancer Research
MedicalResearch.com Interview with: Dr. Wai Keung Leung Professor, Division of Gastroenterology & Hepatology Department of Medicine Assistant Dean, LKS Faculty of Medicine University of Hong Kong Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: It remains controversial whether proton pump inhibitors will increase the risk of gastric cancer. Although previous studies have shown a possible increase in risk in patients taking long-term proton pump inhibitors (PPI), these studies are confounded by the presence of H. pylori infection. In this population-based study from Hong Kong, we have determined the risk of gastric cancer development in more than 63,000 H. pylori-infected subjects who had the bacterium eradicated by a course of  clarithromycin-based triple therapy and continued to take PPI or H2-receptor antagonist (H2RA). After adjusting for various baseline differences among those PPI and non-PPI users, we found that the risk of gastric cancer was increased by 2.4-fold in those who used long-term PPI. The risk was in tandem with the frequency and duration of PPIs treatment. The risk increased from 5-fold to 8-fold for more than 1-year and 3-year use of PPI, respectively. Similar increase in risk was not observed among those who took H2RA, a weaker acid suppressive agent.

29 Mar

Posted at 14:30h in Author Interviews, C. difficile, Gastrointestinal Disease, JAMA, Mayo Clinic
MedicalResearch.com Interview with: [caption id="attachment_33270" align="alignleft" width="166"]Sahil Khanna, Dr. Sahil Khanna[/caption] Sahil Khanna, M.B.B.S. MS Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea and has recently shown increasing incidence especially in the community. Novel risk factors for CDI development include the use of gastric acid suppression medication, presence of systemic comorbid conditions, C difficile carriage in water and food sources, amongst others. Gastric acid suppression medications such as proton-pump inhibitors (PPIs) and histamine-2 receptor blockers (H2Bs) are commonly prescribed and consumed over the counter for gastroesophageal reflux disease, peptic ulcer disease, or functional dyspepsia, but they are also sometimes prescribed for unnecessary indications, which leads to overuse of these medications. Recurrent CDI after a primary infection is a major problem, with the risk being as high as 50% to 60% after 3 or more Clostridium difficile infections. Data on the association between acid suppression and recurrent CDI are conflicting and therefore we performed a systematic review and meta-analysis to study the association between the use of gastric acid suppression medications and the risk of recurrent CDI.

11 Mar

Posted at 17:59h in Author Interviews, Gastrointestinal Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_32846" align="alignleft" width="142"]Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University Dr. Ronnie Fass[/caption] Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? Response: The endoscopic radiofrequency procedure (Stretta) has been used for more than a decade to treat patients with gastroesophageal reflux disease (GERD). Over time, there were several Meta-analyses with variable designs of the Stretta procedure providing conflicting results. Thus, the purpose of the current systematic review and meta-analysis was to determine the efficacy of the Stretta procedure using all currently available controlled and cohort studies.

18 Mar

Posted at 12:14h in Author Interviews, Gastrointestinal Disease, Heart Disease, Pharmacology
MedicalResearch.com Interview with: Giuseppe Gargiulo MD Research fellow in Cardiology Inselspital, University of Bern, Bern, Switzerland  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Gargiulo: Every year millions of people with coronary artery disease are treated worldwide with percutaneous coronary intervention (PCI). Consequently, they receive a dual  (DAPT) in order to prevent thrombotic life-threatening complications, such as stent thrombosis. DAPT often consists of aspirin and clopidogrel, but some studies have questioned the efficacy of clopidogrel in case of concomitant therapy with proton-pump inhibitors (PPI) due to pharmacodynamic interactions. Indeed, clopidogrel is a pro-drug needing to be activated, and this could be potentially affected by PPI. This is a relevant topic given that many patients treated with DAPT commonly receive also a PPI to prevent gastrointestinal complications (ulceration and bleeding) or due to pre-existing gastric disease. Some studies demonstrated that the use of a PPI, mainly omeprazole, was associated with an increased risk of cardiovascular adverse events, indeed the Food and Drug Administration (FDA) and the European Medicine Agency (EMA) discouraged the concomitant use of omeprazole and clopidogrel. On the contrary, some other studies did not confirm this finding. We performed a detailed analysis of the impact of PPI therapy on the 2-year clinical outcomes of 1970 patients undergoing PCI with stent implantation enrolled in the PRODIGY trial (a randomized trial comparing 2 DAPT regimens: 6-month versus 24-month DAPT). In our study population, 738 patients (38%) were treated with a PPI (lansoprazole 90%) concomitantly to DAPT. We found that the ischemic and bleeding events at 2 years of follow-up were similar in patients treated with or without a PPI, irrespective of DAPT duration (6-month or 24-month). These findings support the concept that the concomitant use of PPI, when clinically indicated, in patients receiving clopidogrel is not associated with adverse clinical outcomes.

20 Aug

Posted at 02:26h in Author Interviews, Gastrointestinal Disease, Heart Disease
MedicalResearch.com Interview with: John P. Cooke MD PhD Chair, Department of Cardiovascular Sciences Director, Center for Cardiovascular Regeneration Houston Methodist Research Institute 6670 Bertner St MS: R6-414, Houston, TX 77030John P. Cooke MD PhD Chair, Department of Cardiovascular Sciences Director, Center for Cardiovascular Regeneration Houston Methodist Research Institute 6670 Bertner St MS:  R6-414, Houston, TX 77030   MedicalResearch.com: What are the main findings of the study? Answer: We discovered that the proton pump inhibitors PPIs), as a class, impair vascular relaxation.  The PPIs have this effect by suppressing the activity of a key enzyme required for cardiovascular health. The enzyme is known as DDAH (for dimethylarginine dimethylaminohydrolase).  This enzyme is critical in clearing ADMA (asymmetric dimethylarginine) from tissues and the circulation.  Because ADMA is an endogenous inhibitor of nitric oxide synthase, accumulation of ADMA impairs vascular relaxation and vascular homeostasis.   Previously, we and others have found that, by inhibiting endothelium-derived nitric oxide, ADMA accelerates vascular disease in preclinical models.  In humans, ADMA is linked to the severity of vascular disease, and is an independent risk factor for major adverse cardiovascular events (MACE).  Thus, the effect of PPIs to inhibit DDAH would be anticipated to impair cardiovascular health, and to increase the risk of MACE.