Long-term safety concerns with proton pump inhibitors.
Proton pump inhibitors (PPIs) are among the most widely prescribed medications worldwide. Their use has resulted in dramatic improvements in treatment of peptic ulcer disease and gastroesophageal reflux disease. Despite an acceptable safety profile, mounting data demonstrate concerns about the long-term use of PPIs. To provide a comprehensive review regarding the concerns of long-term PPI use, a literature search was performed to identify pertinent original and review articles. Despite study shortcomings, the collective body of information overwhelmingly suggests an increased risk of infectious complications and nutritional deficiencies. Data regarding any increased risk in gastric or colon malignancy are less convincing. PPIs have revolutionized the management and complications of acid-related disorders with a high margin of safety; however, with the data available, efforts to reduce the dosing of or discontinue the use of PPIs must be reassessed frequently.
Department of Internal Medicine, University of Oklahoma, Oklahoma City, OK, USA. tauseef-ali@ouhsc.edu
Tauseef
T
Ali
David Neil
DN
Roberts
William M
WM
Tierney
D000897:Anti-Ulcer Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002118:Calcium / Q000172:deficiency; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D003677:Deficiency Diseases / Q000139:chemically induced / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000139:chemically induced / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D000090463:Iron Deficiencies; D008134:Long-Term Care; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010024:Osteoporosis / Q000139:chemically induced / Q000453:epidemiology; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D017751:Safety Management; D013274:Stomach Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D013997:Time Factors
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D002118:Calcium