When is proton pump inhibitor use appropriate? - PubMed (original) (raw)

Editorial

When is proton pump inhibitor use appropriate?

Rena Yadlapati et al. BMC Med. 2017.

Abstract

Proton pump inhibitor (PPI) therapy is commonly used outside of Food and Drug Administration indication for a broad range of conditions such as extra-esophageal reflux and PPI-responsive esophageal eosinophilia. While this may be appropriate in some scenarios, it has also resulted in widespread inappropriate PPI use. At the same time, data suggesting adverse effects of long-term PPI therapy are multiplying, albeit mainly from low quality studies. The systematic review by Scarpignato et al. (BMC Med 14:179, 2016) addresses this dilemma with a comprehensive analysis of the risks and benefits of PPI use. The authors concluded that, while PPIs are highly efficacious in erosive acid-peptic disorders, efficacy is not equaled in other conditions. In some instances, they found no supportive evidence of benefit. With respect to side effects, they indicated that the questionable harms associated with PPI therapy do not outweigh the benefits afforded by appropriate PPI use. However, inappropriate PPI use results in increased healthcare costs and unnecessary exposure to potential adverse effects. Ideally, PPI therapy should be personalized, based on indication, effectiveness, patient preference, and risk assessment.Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0718-z .

Keywords: Gastroesophageal reflux disease; Indication; Proton pump inhibitors.

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References

    1. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterology. 2009;136:376–86. doi: 10.1053/j.gastro.2008.12.015. -DOI -PubMed
    1. Howden CW, Kahrilas PJ. Editorial: just how "difficult" is it to withdraw PPI treatment? Am J Gastroenterol. 2010;105:1538–40. doi: 10.1038/ajg.2010.91. -DOI -PubMed
    1. Scarpignato C, Gatta L, Zullo A, et al. Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression. BMC Med. 2016;14:179. doi: 10.1186/s12916-016-0718-z. -DOI -PMC -PubMed
    1. Qadeer MA, Phillips CO, Lopez AR, et al. Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a meta-analysis of randomized controlled trials. Am J Gastroenterol. 2006;101:2646–54. doi: 10.1111/j.1572-0241.2006.00844.x. -DOI -PubMed
    1. Naik RD, Vaezi MF. Extra-esophageal manifestations of GERD: who responds to GERD therapy? Curr Gastroenterol Rep. 2013;15:318. doi: 10.1007/s11894-013-0318-4. -DOI -PubMed

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