Proton Pump Inhibitors and Lower Serum Ferritin Levels in 171 HFE C282Y Homozygotes in the Hemochromatosis and Iron Overload Screening Study

Barton, James C.; Adams, Paul C.; Acton, Ronald T.; Speechley, Mark; McLaren, Christine E.; McLaren, Gordon D.; Eckfeldt, John H.

doi:10.4172/vms.1000112

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…The following exclusion criteria were used: studies that did not evaluate patients with HFE-related hemochromatosis, studies that did not have PPIs as one of the interventions arms and studies that overlapped the selected studies (studies from the same study group, institution and period of inclusion), case reports, reviews, editorials and correspondence letters that did not report their own data. Finally, one study was excluded as it used a different statistical method to report results, and we could not adjust arithmetic means with accuracy for given geometric means [14].…”

Section: Eligibility Criteriamentioning

confidence: 99%

Proton pump inhibitors reduce phlebotomy burden in patients with HFE-related hemochromatosis: a systematic review and meta-analysis

Dirweesh

Anugwom

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Background and aims Proton pump inhibitors (PPIs) may reduce iron absorption and serum ferritin levels in patients with homeostatic iron regulator (HFE)-related hemochromatosis, reducing the need for frequent phlebotomies. Our study aimed to perform for the first time a meta-analysis of existing observational and randomized controlled studies to ascertain the overall effect of PPI use in patients with HFE-related hemochromatosis. Methods Studies in adults reporting the outcomes of PPIs use in hereditary hemochromatosis patients from Medline, Embase, Scopus and Google Scholar databases from inception to December 2019 were systematically searched. The study outcomes were the serum ferritin levels and annual requirement for phlebotomies. Pooled mean difference, and 95% confidence intervals (CIs) were obtained by the random-effects model. Forrest plots were constructed to show the summary pooled estimate. Heterogeneity was assessed by using I2 measure of inconsistency. Results Following an initial search of 202 manuscripts, a total of three studies involving 68 patients with hemochromatosis (34 in the PPIs group and 34 in the placebo or non-PPI group) were included. A minimum duration of PPI use was 1 year. Patients who received PPIs therapy did not have a statistically significant lower serum ferritin levels (mean difference: −18.86, 95% CI: −60.44, 22.72, P = 0.37, I 2 = 88%) but required significantly less sessions of phlebotomies annually (mean difference: −3.10, 95% CI: −4.46, −3.08, P < 0.00001, I 2 = 93%). No publication bias was found on Egger (P = 0.94) or Begg (P = 0.98) tests. Conclusion PPIs can be used as an adjuvant therapy to reduce phlebotomy burden in patients with HFE-related hemochromatosis.

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Section: Eligibility Criteriamentioning

confidence: 99%

Proton pump inhibitors reduce phlebotomy burden in patients with HFE-related hemochromatosis: a systematic review and meta-analysis

Dirweesh

Anugwom

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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“…Many of these reports have attracted attention in the lay and professional press. 2,3 Gastroenterologists are increasingly asked about the safety of long-term PPI therapy. Although the possibility of PPIs increasing the risk of adverse outcomes has resulted appropriately in scrutiny of patients taking PPIs for questionable indications or at doses higher than necessary, it has also produced exaggerated concerns by patients and physicians about appropriate PPI use.…”

Section: Paul C Adams Department Of Medicine University Hospital Lonmentioning

confidence: 99%

“…In the Hemochromatosis and Iron Overload Screening Study, a regression model in 171 C282Y homozygotes showed that PPI use was associated with a lower serum ferritin (Figure 1). 2 In this issue, Vanclooster et al, 3 have conducted a randomized trial in 30 C282Y homozygotes for hemochromatosis, to study the effects of daily PPI (pantoprazole 40 mg) on iron stores as assessed by serum ferritin. All patients had phlebotomy if their serum ferritin rose above 100 mg/ L and over one year, participants on PPI therapy required 1.33 less phlebotomies.…”

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confidence: 99%

“…Geometric mean serum ferritin in untreated male and female C282Y homozygotes on PPI therapy (-) and not on PPI therapy (,). 2 benefit most patients 9 which is why we do not recommend a reduced iron diet. Drinking English tea and taking PPI therapies are other adjunctive therapies but are unlikely to bring the serum ferritin into the low normal range in patients that require maintenance.…”

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confidence: 99%

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