Effectiveness of androgen receptor pathway inhibitors and proton pump inhibitors

Abstract

To the Editor, We read with great interest the comprehensive study by Tanegashima et al. titled "Impact of proton pump inhibitors on the efficacy of androgen receptor signaling inhibitors in metastatic castration-resistant prostate cancer patients." 1 We commend the authors for their thorough work. However, we believe that addressing a few points regarding the study would be beneficial.First, proton pump inhibitors (PPIs) are among the most frequently prescribed medications in contemporary clinical practice, giving rise to concerns about the potential for adverse effects associated with long-term use. 2 The primary predictors of PPI use among patients are the number of comorbidities and the quantity of medications they are taking. 3,4 On the other hand, despite the absence of a consensus on the definition of long-term PPI use, there is a general agreement that usage for 6 months or more can be considered longterm use in pharmacoepidemiological studies. 5 Considering these factors, to more accurately evaluate the effect of PPIs on the effectiveness of androgen receptor signaling inhibitors, we believe it would be more appropriate to include the study population's comorbidities, concurrent medication use, and duration of PPI use in the analysis.