25 Years of Proton Pump Inhibitors: A Comprehensive Review

Abstract

Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease. Despite their overall efficacy, PPIs do have some limitations related to their short plasma half-lives and requirement for meal-associated dosing, which can lead to breakthrough symptoms in some individuals, especially at night. Longer-acting PPIs and technology to prolong conventional PPI activity have been developed to specifically address these limitations and may improve clinical outcomes.

Proton pump inhibitors and risk of gastric cancer in a case–control study

“…Proton pump inhibitors are widely used for the management of peptic ulcer disease, gastroesophageal reflux disease and eradication of Helicobacter pylori infection 5. However, its safety for long-term use has raised pubic concern 6.…”

Proton Pump Inhibitors: Risks and Rewards and Emerging Consequences to the Gut Microbiome

“…Interestingly, it has been shown repeatedly that more than half of their use is without any clear indication, and often for prolonged periods of time. This misuse, besides subjecting patients to potential adverse effects, poses a significant financial burden for the healthcare system …”

“…Patients who fail to comply to diet changes often prefer medications. Since the initial release in the late 1980s of omeprazole, proton pump inhibitors (PPIs) have dominated the global medication market . According to the package insert, they are indicated for GERD, peptic ulcer disease (PUD), GI bleeding, and in patients taking long‐term non‐steroidal anti‐inflammatory drugs (NSAIDs) .…”

Are we missing tracks while prescribing proton pump inhibitors? - An opinion from clinicians cross sectional hospital based questionnaire study

“…5,6 Gastro-oesophageal reflux is a common medical problem associated with reflux movement of gastric contents into the oesophagus can cause a varying range of symptoms, from hiccups and burp to pain and physical discomfort. 7 As of 2016, there are six PPIs approved by the United States Food and Drug Administration (FDA) 8 and DCGI in India. …”