Could proton pump inhibitors cause cancer?

Rösch, Paul

doi:10.1586/17512433.2014.867233

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…We envisage that enteropathy induced by the combination of an NSAID and a PPI is common but often clinically silent, yet lesions induced by these drugs in the small intestine could be of considerable clinical importance. [66][67][68][69][70] In accordance with current recommendations of gastroenterology and cardiology societies, the use of concomitant PPIs and NSAIDs is considered appropriate to reduce the risk of bleeding in individuals 65 years and older, those with a history of peptic ulcer disease or GI bleeding, those using more than 1 antiplatelet drug, or in combination with anticoagulants, oral biphosphonates, serotonin reuptake inhibitors, or systemic corticosteroids. [8][9][10] Capsule endoscopy studies have revealed that adding PPIs to NSAIDs results in a higher frequency of mucosal lesions in the small intestine in comparison to that seen in patients taking NSAIDs only.…”

Section: Ppis Exacerbate Nsaid-induced Mucosal Lesions In the Small Imentioning

confidence: 99%

Nonsteroidal Anti-inflammatory Drugs, Proton Pump Inhibitors, and Gastrointestinal Injury: Contrasting Interactions in the Stomach and Small Intestine

Marlicz

Łoniewski²,

Grimes

et al. 2014

Mayo Clinic Proceedings

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Nonsteroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) are among the most frequently prescribed groups of drugs worldwide. The use of NSAIDs is associated with a high number of significant adverse effects. Recently, the safety of PPIs has also been challenged. Capsule endoscopy studies reveal that even low-dose NSAIDs are responsible for gut mucosal injury and numerous clinical adverse effects, for example, bleeding and anemia, that might be difficult to diagnose. The frequent use of PPIs can exacerbate NSAID-induced small intestinal injury by altering intestinal microbiota. Thus, the use of PPI is considered to be an independent risk factor associated with NSAID-associated enteropathy. In this review, we discuss this important clinical problem and review relevant aspects of epidemiology, pathophysiology, and management. We also present the hypothesis that even minor and subclinical injury to the intestinal mucosa can result in significant, though delayed, metabolic consequences, which may seriously affect the health of an individual. PubMed was searched using the following key words (each key word alone and in combination): gut microbiota, microbiome, non-steroidal anti inflammatory drugs, proton pump inhibitors, enteropathy, probiotic, antibiotic, mucosal injury, enteroscopy, and capsule endoscopy. Google engine search was also carried out to identify additional relevant articles. Both original and review articles published in English were reviewed.

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Section: Ppis Exacerbate Nsaid-induced Mucosal Lesions In the Small Imentioning

confidence: 99%

Nonsteroidal Anti-inflammatory Drugs, Proton Pump Inhibitors, and Gastrointestinal Injury: Contrasting Interactions in the Stomach and Small Intestine

Marlicz

Łoniewski²,

Grimes

et al. 2014

Mayo Clinic Proceedings

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“…7 One possible explanation is that bile and pancreatic enzymes that would previously have been inactivated by hydrochloric acid can irritate and cause metaplasia in oesophageal tissue. 8 Since PPIs are often difficult to stop because of severe rebound symptoms, they may actually cause GERD rather than prevent it. 9, 10 Although counterintuitive, the same may hold true for adenocarcinoma of the oesophagus.…”

mentioning

confidence: 99%

Letter: proton pump inhibitors, GERD and oesophageal adenocarcinoma

Rösch

2014

Aliment Pharmacol Ther

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Inibidores da bomba de protões e o risco de eventos adversos graves – uma bomba cardiovascular?

Cunha

Machado

2018

Revista Portuguesa de Cardiologia

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Proton pump inhibitors are currently one of the most prescribed pharmacological classes in developed countries, given their effectiveness and safety profile, which has until now been considered favorable. However, in recent years, several papers have been published that associate prolonged use of these drugs with a wide range of adverse effects, posing doubts about their safety. Among the adverse effects described is an increased risk of cardiovascular events. This relationship was first described in subjects after acute coronary syndrome due to the interference of proton pump inhibitors in the cytochrome P450 2C19 and the conversion of clopidogrel to its active metabolite. More recent studies have also reported this relationship with the use of antiplatelet agents that do not depend on cytochrome P450 2C19 activation. The proposed mechanism is inhibition of dimethylarginine dimethylaminohydrolase, a physiological inhibitor of asymmetric dimethylarginine, which increases plasma concentrations of the latter enzyme, leading to lower levels of nitric oxide. By reviewing in this article the relationship between the use of proton pump inhibitors and increased risk of cardiovascular and cerebrovascular events, the authors aim to alert the medical community to the potentially harmful effects of these drugs, and recommend the setting of a moratorium on their prolonged use.

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Could proton pump inhibitors cause cancer?

Cited by 4 publications

References 13 publications

Nonsteroidal Anti-inflammatory Drugs, Proton Pump Inhibitors, and Gastrointestinal Injury: Contrasting Interactions in the Stomach and Small Intestine

Nonsteroidal Anti-inflammatory Drugs, Proton Pump Inhibitors, and Gastrointestinal Injury: Contrasting Interactions in the Stomach and Small Intestine

Letter: proton pump inhibitors, GERD and oesophageal adenocarcinoma

Inibidores da bomba de protões e o risco de eventos adversos graves – uma bomba cardiovascular?

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