Risk Evaluation of Proton Pump Inhibitors for Panitumumab-Related Hypomagnesemia in Patients with Metastatic Colorectal Cancer

Katsura, Hideyuki; Suga, Yukio; Kubo, Anna; Sugimura, Hayato; Kumatani, Kaname; Haruki, Kazunobu; Yonezawa, Miwa; Narita, Ayaka; Ishijima, Rei; Ikesue, Hiroaki; Toi, Hitomi; Takata, Naoko

doi:10.1248/bpb.b23-00641

Cited by 1 publication

(1 citation statement)

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“…While their efficacy for several medical indications is well-established, the long-term use of PPIs has raised concerns regarding potential negative sequela. For example, the prolonged use of PPIs has been associated with a reduced absorption of certain nutrients, such as magnesium [2,3], calcium [4] or vitamin B12 [5]. This can lead to complications such as osteoporosis, with an increased risk of fractures [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Intake of Proton-Pump Inhibitors Could Be Associated with an Increased Incidence of Liver Cancer in Women

Loosen,

Jördens,

Leyh

et al. 2024

Cancers

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Background: Proton pump inhibitors (PPIs) are among the most commonly prescribed drugs in gastroenterology. Although PPIs are mostly well tolerated, long-term PPI intake has been linked with diabetes mellitus, osteoporosis and infectious disease. In the present study, we evaluated a potential association between PPI intake and a subsequent diagnosis of liver cancer in a large real-world cohort of outpatients in Germany. Methods: A total of 1766 patients with liver cancer, as well as 8830 propensity-score-matched controls, were identified from the Disease Analyzer database (IQVIA). The outcome of the study was the association between PPI use and a subsequent diagnosis of liver cancer, which was evaluated using multivariable logistic regression analyses. Results: Overall, 42.9% of the liver cancer patients and 39.0% of the controls received at least one PPI prescription before the index date. PPI prescriptions at any time before the index date were associated with an increased risk of subsequent liver cancer (OR: 1.18; 95% CI: 1.06–1.31). The positive association was observed in all age groups, as well as in women and men, but only in women (OR: 1.30; 95% 1.09–1.55) did it reach the predefined level of significance (p < 0.01). When considering the duration of PPI therapy, only PPI therapy for at least two years was significantly associated with an increased risk of liver cancer (OR: 1.28; 95% 1.09–1.50). In an analysis stratified by age and sex, this association was strongest in the age group < 60 years (OR: 1.99; 95% 1.21–3.26). Conclusions: Our data suggest that long-term PPI intake in women as well as in patients < 60 years might be associated with an increased risk of liver cancer. These findings support current efforts to reduce the inappropriate use of PPIs in routine clinical practice and to link PPI prescribing to a clear medical indication.

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