Increased risk of death associated with the use of proton‐pump inhibitors in patients with dementia and controls – a pharmacoepidemiological claims data analysis

Çetin, Hakan; Wurm, Raphael; Reichardt, Berthold; Tomschik, Matthias; Silvaieh, Sara; Parvizi, Tandis; König, Theresa; Erber, Astrid; Schernhammer, Eva; Stamm, Tanja; Stögmann, Elisabeth

doi:10.1111/ene.14252

Cited by 4 publications

(3 citation statements)

References 30 publications

(35 reference statements)

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“…Although usually considered safe, these drugs have been associated with increased risks of side effects such as bone fractures, kidney disease, microscopic colitis, and hypomagnesaemia [14]. Furthermore, the long-term use of PPIs was recently reported to be associated with an increased mortality risk [4], and an increased dementia risk [9]. PPIs decrease intracellular pH and increase the extracellular pH via inhibition of vacuolar H + -ATPases (V-ATPases) in a covalent interaction [20].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic prevention of COVID-19 in elderly: a case–control study

et al. 2021

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including antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors (PPIs), oral antidiabetics (OADs), corticosteroids, immunosuppressants), comorbidities, symptoms, laboratory values, and clinical outcome were all collected. COVID-pos patients more frequently had a history of diabetes (P = .016) and alcoholism (P = .023), a lower leukocyte count (P = .014) and a higher mortality rate -29.2% versus 14.4% -(P = .014) when compared to COVID-neg patients. Patients on PPIs were 2.3 times less likely (odds ratio [OR] = 0.4381, 95% confidence interval [CI] [0.2331, 0.8175], P = .0053) to develop COVID-19 infection, compared to those not on PPIs. No other treatment decreased or increased this risk. COVID-pos patients on antipsychotics (P = .0013) and OADs (P = .0153), particularly metformin (P = .0237), were less likely to die. Thus, patients on treatment with PPI were less likely to develop COVID-19 infection, and those on antipsychotics or metformin had a lower risk of mortality. However, prospective studies, including clinical trials, are needed to confirm or not these findings.

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Section: Discussionmentioning

confidence: 99%

Therapeutic prevention of COVID-19 in elderly: a case–control study

et al. 2021

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“…Although we did not find an association between PPI use and ALS risk in the present study, the role of PPIs on the survival of ALS patients needs to be studied further. A study of US veterans found an increased mortality among PPI users 28 , and a more recent study from Austria reported an increased mortality risk associated with PPI use among dementia patients and controls 29 . In terms of ALS, only one study examined the effect of various medications including PPIs on the disease course and failed to show a statistically significant relationship between PPIs and ALS survival after correction for multiple testing 30 .…”

Section: Discussionmentioning

confidence: 99%

No association between proton pump inhibitor use and ALS risk: a nationwide nested case–control study

Çetin

Sun

Almqvist

et al. 2020

Sci Rep

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fang fang 2* & caroline ingre 6 the use of proton pump inhibitors (ppis) has been proposed as a potential risk factor for neurodegenerative diseases, but little is known regarding its role in amyotrophic lateral sclerosis (ALS). We therefore aimed to assess the association of ppi use with the subsequent risk of ALS, and performed a register-based nationwide nested case-control study, including 2,484 ALS cases diagnosed during July 2006-December 2013 in Sweden and 10 population controls per case that were individually matched to the case by sex, age, and area of residence. Dispenses and cumulative defined daily doses (cDDDs) of PPIs were extracted from the Swedish Prescribed Drug Register. the association of ppi use with the risk of ALS was assessed using conditional logistic regression, after applying different lag windows to avoid reverse causation. ALS patients were more likely to be dispensed with ppis before diagnosis than controls. However, previous ppi use was not associated with an increased risk of ALS (OR = 1.08, 95% CI 0.97-1.19), and there was no dose-response relationship between cDDDs of PPIs and ALS risk (p = 0.0874), after excluding dispenses during the year before ALS diagnosis. The results were similar after excluding dispenses during the 2 or 3 years before ALS diagnosis.

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“…Although usually considered safe, these drugs have been associated with increased risks of side effects such as bone fractures, kidney disease, microscopic colitis, and hypomagnesaemia. 14 Furthermore, the longterm use of PPIs was recently reported to be associated with an increased mortality risk, 16 and an increased dementia risk. 17 PPIs decrease intracellular pH and increase the extracellular pH via inhibition of vacuolar H + -ATPases (V-ATPases) in a covalent interaction.…”

Section: Discussionmentioning

confidence: 99%

Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study

Blanc¹,

Waechter²,

Vogel³

et al. 2020

Preprint

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Background: COVID-19 is a disease of the elderly as 95% of deaths related to COVID-19 occur in people over 60 years of age. Despite the urgent need for a preventive treatment there are currently no serious leads, other than the vaccination. Objective: To find a preventive treatment of COVID-19 in elderly patients. Design: Retrospective case-control study. Setting: Robertsau Geriatric Hospital of the University Hospitals of Strasbourg, France. Patients: 179 elderly patients who had been in contact with the SARS-CoV-2, of whom 89 had tested RT-PCR-positive (COVID-pos) for the virus and 90 had tested RT-PCR-negative (COVID-neg). Measurements: Treatments within 15 days prior to RT-PCR (including antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors (PPIs), paracetamol, anticoagulant, oral antidiabetics (OADs), corticosteroids, immunosuppressants), comorbidities, symptoms, laboratory values, and clinical outcome were all collected using the electronic patient record. Results: COVID-pos patients more frequently had a history of diabetes (P=.016) and alcoholism (P=.023), a lower leukocyte count (P=.014) and a higher mortality rate– 29.2% versus 14.4% – (P=.014) when compared to COVID-neg patients. Patients on PPIs were 2.3 times less likely (odds ratio [OR] = 0.4381, 95% confidence interval [CI] [0.2331, 0.8175], P=.0053) to develop COVID-19 infection, compared to those not on PPIs. No other treatment decreased or increased this risk. COVID-19 patients on antipsychotics (P=.0013) and OADs (P=.0166) were less likely to die. Limitations: retrospective study. Conclusion: PPIs treatment lowered the risk of development of COVID-19 infection, and antipsychotics and OADs decreased the risk of mortality in geriatric patients. If further studies confirm this finding, PPIs could be used preventatively in the elderly in this pandemic context. Moreover, OADS and antipsychotics should be tested in clinical trials.

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Increased risk of death associated with the use of proton‐pump inhibitors in patients with dementia and controls – a pharmacoepidemiological claims data analysis

Cited by 4 publications

References 30 publications

Therapeutic prevention of COVID-19 in elderly: a case–control study

Therapeutic prevention of COVID-19 in elderly: a case–control study

No association between proton pump inhibitor use and ALS risk: a nationwide nested case–control study

Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study

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