Are proton pump inhibitors suitable medicines to prevent upper gastrointestinal events due to non-steroidal anti-inflammatory drugs?

Response to Comment on ‘Proton Pump Inhibitors. Risks and Rewards and Emerging Consequences to the Gut Microbiome’

“…We have suggested having a clear indication before starting PPI because of possible predisposition to CAP, even though the risk might be minimal. The majority of the references used by Toda et al were also included in our paper. Also, there are some data even suggesting the association between PPI and CAP is likely to be due to the presence of confounding factors .…”

“…Regarding the risk of hip fracture mentioned by Islam and colleagues, it was unavailable to us at the time of submission, and we acknowledge that there might be a higher risk of osteoporosis and hip fracture in long‐term PPI users. The risk vs benefit should be assessed before initiation and at periodic intervals as well as considering alternative therapies to avoid any increased risk of fractures with PPI use.…”

Response to letter to the editor: ‘are proton pump inhibitors suitable medicines to prevent upper gastrointestinal events due to non-steroidal anti-inflammatory drugs?'

“…We appreciate Dr. Toda's thought provoking letter highlighting the important safety concerns regarding proton pump inhibitors (PPIs) 1 . We would like to emphasize the fact that the core treatments recommended by the OARSI Guideline panel for all patients with osteoarthritis consists exclusively of non-pharmacologic options 2 .…”

Comment on “Proton Pump Inhibitor Use and Risk of Developing Alzheimer’s Disease or Vascular Dementia: A Case–Control Analysis”

“…The association between proton pump inhibitor (PPI) use and dementia is controversial [1]. In this issue of Drug Safety, Imfeld et al…”

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Dear Editor,The association between proton pump inhibitor (PPI) use and dementia is controversial [1]. In this issue of Drug Safety, Imfeld et al[2] reported as follows: "As compared to non-use, long-term PPI use (≥ 100 prescriptions) was not associated with an increased risk of developing AD (Alzheimer's disease) [aOR (adjusted odds ratio) 0.88, 95% CI (confidence interval) 0.80-0.97] or VaD (vascular dementia) (aOR 1.18, 95% CI 1.04-1.33)" [2].

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