title: Proton pump inhibitor use for 12 months is not associated with changes in serum magnesium levels: a prospective open label comparative study.
abstract: OBJECTIVE
  Proton pump inhibitors (PPIs) are a widely used class of drugs because of a generally acceptable safety profile. Among recently raised safety issues of the long-term use of PPIs is the increased risk of developing hypomagnesemia. As there have been very few prospective studies measuring serum magnesium levels before and after PPI therapy, we aimed to prospectively assess the potential association between PPI therapy for 12 months and the risk of hypomagnesemia as well as the incidence of new-onset hypomagnesemia during the study. In addition, the association of PPI therapy with the risk of hypocalcemia was assessed.
  
  
  METHODS
  The study included 250 patients with normal serum magnesium and total calcium levels, who underwent a long-term PPI treatment. Serum magnesium, total calcium, and parathormone (PTH) levels were measured at baseline and after 12 months.
  
  
  RESULTS
  Of the 250 study participants, 209 completed 12 months of treatment and were included in the statistical analysis. The Wilcoxon signed rank test showed no statistically significant differences in serum magnesium levels between measurements at two different time points. However, there were statistically significant differences in serum total calcium and PTH levels in PPI users.
  
  
  CONCLUSIONS
  Stable serum magnesium levels were demonstrated after 12 months and no association between PPI use and risk of hypomagnesemia was shown in the general population. Significant reductions of serum total calcium levels were demonstrated among PPI users; nevertheless, further research is required before recommending any serum calcium and PTH level monitoring in patients initiated on long-term PPI therapy.
authors.affiliation: Department of Pharmacology, Prishtina University School of Medicine, Prishtina, Kosovo. hasime.qorraj@uni-pr.edu.
authors.forename: Elton
authors.initials: E
authors.lastname: Bahtiri
authors.forename: Hilmi
authors.initials: H
authors.lastname: Islami
authors.forename: Rexhep
authors.initials: R
authors.lastname: Hoxha
authors.forename: Afrim
authors.initials: A
authors.lastname: Gashi
authors.forename: Kujtim
authors.initials: K
authors.lastname: Thaçi
authors.forename: Çağla
authors.initials: Ç
authors.lastname: Karakulak
authors.forename: Shpetim
authors.initials: S
authors.lastname: Thaçi
authors.forename: Hasime
authors.initials: H
authors.lastname: Qorraj Bytyqi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000139:chemically induced; D007592:Joint Diseases / Q000097:blood / Q000188:drug therapy*; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D013995:Time; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors; D008274:Magnesium; D002118:Calcium