The prevalence of pantoprozole associated thrombocytopenia in a community hospital.
OBJECTIVE
Proton pump inhibitors (PPIs) are widely used in the treatment of gastritis, gastroesophageal reflux disease and peptic ulcer disease. Thrombocytopenia is not listed as one of the main side effects of PPI therapy. However, there have been documented cases of thrombocytopenia with the use of PPIs in the literature. Our objective was to determine whether exposure to PPIs leads to an increased incidence of thrombocytopenia in hospitalized patients.


METHODS
This retrospective cohort study examined the platelet counts of 468 hospitalized patients who were 18 - 80 years of age, were prescribed pantoprazole for a minimum of 3 days and were matched to 468 non-medicated controls. The primary outcome was defined as either a drop in the platelet count by >/= 50% relative to baseline, or a drop to < 150,000/ml. Exclusion criteria were baseline thrombocytopenia and hospitalization for < 3 days.


RESULTS
No difference was found in the occurrence of thrombocytopenia between the two groups (6.2%; 95% CI = 4.1 - 8.7%) in the study group versus (6.6%; 95% CI = 4.5 - 9.2%) in the control group (p = 0.90). Post-hoc analysis revealed a higher incidence of > 20% drop in platelet count in the study group compared with the controls (23%; 95% CI = 19 - 27% versus 11%; 95% CI = 8 - 14%, respectively; p < 0.001).


CONCLUSIONS
This study failed to demonstrate an increased incidence of thrombocytopenia for patients treated with pantoprazole. Our study adds support to the favorable safety profile of PPI therapy in hospitalized patients. Further investigation is needed to evaluate the effects of PPI use in the outpatient setting.
Dotan
Efrat
E
Lenox Hill Hospital, Department of Hematology, 100 East 77th street, New York, NY 10021 +1 212 434 2000 ; +1 212 434 2446 ; cspaccavento@lenoxhill.net.
Katz
Randi
R
Bratcher
Jason
J
Wasserman
Carrie
C
Liebman
Michelene
M
Panagopoulos
Georgia
G
Spaccavento
Colette
C
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D015995:Prevalence; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000077402:Pantoprazole