Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Filion, Kristian B.; Château, Dan; Targownik, Laura E.; Gershon, Andrea S.; Durand, Madéleine; Tamim, Hani; Teare, Gary; Ravani, Pietro; Ernst, Pierre; Dormuth, Colin R.

doi:10.1136/gutjnl-2013-304738

Cited by 159 publications

(122 citation statements)

References 34 publications

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“…However, a large retrospective study (Filion et al, 2014) in new PPI users with strict criteria to avoid biases and a limited time observation (6 months) failed to show a higher risk of hospitalization for community-acquired pneumonia. Consequently further data are needed.…”

Section: Pneumoniamentioning

confidence: 99%

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Numico

Fusco

Franco

et al. 2017

Critical Reviews in Oncology/Hematology

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Section: Pneumoniamentioning

confidence: 99%

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Numico

Fusco

Franco

et al. 2017

Critical Reviews in Oncology/Hematology

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“…Another possible adverse effect of PPIs is on the homeostasis of the gastric microbiome and risk of microbial infection. This concern was partially alleviated by a recent metaanalysis of an observational study that found no statistically significant increase in the risk of hospitalization for community-acquired pneumonia among PPI users (57).…”

Section: Pulmonary Perspectivementioning

confidence: 99%

Idiopathic Pulmonary Fibrosis: Novel Concepts of Proton Pump Inhibitors as Antifibrotic Drugs

Ghebre

Raghu

2016

Am J Respir Crit Care Med

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The prevalence of abnormal acid gastroesophageal reflux (GER) is higher in patients with idiopathic pulmonary fibrosis (IPF) than in matched control subjects. Several studies demonstrated that more than one-third of patients with IPF have abnormal esophageal acid exposures. In addition, many of these studies indicate that the majority of patients with IPF have silent reflux with no symptoms of GER. Findings of abnormal reflux persist in a large proportion of patients with IPF placed on antacid therapy such as proton pump inhibitors (PPIs). This seemingly paradoxical observation suggests that either patients with IPF are somehow resistant to PPI-based intervention or PPIs are inherently unable to suppress acid GER. By contrast, patients with IPF who undergo Nissen fundoplication surgery are effectively relieved from the complications of GER, and retrospective studies suggest improved lung function. Retrospective, anecdotal data suggest a beneficial role of PPIs in IPF including stabilization of lung function, reduction in episodes of acute exacerbation, and enhanced longevity. The recent evidence-based guidelines for treatment of IPF approved conditional recommendation of PPIs for all patients with IPF regardless of their GER status. Recently, we have reported that PPIs possess antiinflammatory and antifibrotic activities by directly suppressing proinflammatory cytokines, profibrotic proteins, and proliferation of lung fibroblasts. Our study provides an alternative explanation for the beneficial effect of PPIs in IPF. In this Perspective, we reviewed emerging progress on antifibrotic effect of PPIs using IPF as a disease model. In addition, we summarized surgical and pharmacological interventions for GER and their downstream effect on lung physiology.

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“…Several epidemiological studies have linked PPIs to increased risk of community-acquired pneumonia, especially during the first days of prescription (21,22); in 2011 a meta-analysis confirmed the association with an OR of 1.27 (95% CI 1.11 to 1.26) (23). However, in more recent studies, this association has not been observed (24,25).…”

Section: Overuse and Its Consequencesmentioning

confidence: 99%

Practical considerations in the management of proton-pump inhibitors

Aguilera¹,

Martín-de-Argila-dePrados²,

Albillos-Martínez³

2015

Rev Esp Enferm Dig

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Proton-pump inhibitors (PPIs) are one of the most active ingredients prescribed in Spain. In recent decades there has been an overuse of these drugs in both outpatient clinics and hospitals that has lead to a significant increase in healthcare spending and to an increase in the risk of possible side effects. It is important for health professionals to know the accepted indications and the correct doses for the use of these drugs. On the market there are different types of PPI: omeprazole, pantoprazole, lansoprazole, rabeprazole and esomeprazole. Omeprazole is the oldest and most used PPI, being also the cheapest. Although there are no important differences between PPIs in curing diseases, esomeprazole, a newgeneration PPI, has proved to be more effective in eradicating H. pylori and in healing severe esophagitis compared to other PPIs. In recent years the use of generic drugs has spread; these drugs have the same bioavailability than the original drugs. In the case of PPIs, the few comparative studies available in the literature between original and generic drugs have shown no significant differences in clinical efficacy.Key words: Proton-pump inhibitor. PPI. Omeprazole. Pantoprazole. Lansoprazole. Rabeprazole. Esomeprazole. INTRODUCTIONProton-pump inhibitors (PPIs) represent a family of drugs widely used in our country. The advent in the nineties of PPIs was a great revolution in the treatment of ulcer disease and gastroesophageal reflux. The main problems of PPIs at present time are its overuse and the errors in the therapeutic indication. This fact leads to a considerable health economic cost and the risk of long-term side effects. In this review the main problems of PPIs prescription, their indications, the differences between PPIs and tips on their use are discussed. Brief historical memory: since alkaline diets until PPIsThe treatment of ulcer disease and gastroesophageal reflux disease (GERD) in the early twentieth century was the prescription of alkaline foods like milk, eggs and puree (1). Later, there were products as sodium bicarbonate that improved symptoms but did not prevent complications. Surgical treatment consisted of different types of gastric surgeries for peptic ulcer disease and Nissen fundoplication for GERD (2).In the mid twentieth century the use of muscarinic antagonists was introduced, atropine being its main active ingredient. Acids secretion was partially inhibited by blocking the muscarinic receptor of the parietal cell. However, these drugs had little effectiveness and numerous adverse effects due to the amount of muscarinic receptors distributed throughout the body. E-type prostaglandin was discovered later, but, again, the limitations of these substances were their short half life and side effects. An important progress in gastric antisecretory therapy was the appearance of H 2 receptors antagonists (H 2 blockers) (3). The most used were ranitidine and famotidine. These drugs established a substantial change by blocking the action of histamine receptor in gastric parietal ...

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Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Cited by 159 publications

References 34 publications

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Idiopathic Pulmonary Fibrosis: Novel Concepts of Proton Pump Inhibitors as Antifibrotic Drugs

Practical considerations in the management of proton-pump inhibitors

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