PMID- 27321544
OWN - NLM
STAT- MEDLINE
DCOM- 20170615
LR  - 20220408
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 48
IP  - 8
DP  - 2016 Aug
TI  - Are proton pump inhibitors really so dangerous?
PG  - 851-9
LID - S1590-8658(16)30435-2 [pii]
LID - 10.1016/j.dld.2016.05.018 [doi]
AB  - For decades, millions of patients with acid-related disorders have had their acid 
      inhibited effectively and safely first with H2-receptor antagonists (H2RAs) and 
      then with proton pump inhibitors (PPI). As with any pharmacological agent, PPIs 
      have been reported to be associated with some adverse events, but several recent 
      large-scale observational studies have evidenced new and serious abnormalities 
      generally linked to their chronic use. However, these studies have often 
      important limitations for their frequent retrospective design and other 
      methodological drawbacks, such as selection biases of the analyzed populations 
      and the presence of various confounding factors. Overall, although the 
      conclusions of these pharmacovigilant investigations must be taken into account 
      and can generate important hypotheses for future research, they do not have to 
      create panic among patients and alarmism among physicians. On considering the 
      weakness of these studies, we suggest physicians should not refrain from 
      continuing to use PPIs, if these drugs are given for medical indications clearly 
      established in the literature and, more importantly, they should not be induced 
      to shift to H2RAs, a class of antisecretory agents that are much less effective 
      than PPIs. A return to the past is potentially dangerous for the patients, taking 
      into account the well-known success of PPIs in the wide spectrum of all 
      acid-related conditions.
CI  - Copyright (c) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Savarino, Vincenzo
AU  - Savarino V
AD  - Division of Gastroenterology, Department of Internal Medicine, University of 
      Genoa, Genoa, Italy. Electronic address: vsavarin@unige.it.
FAU - Dulbecco, Pietro
AU  - Dulbecco P
AD  - Division of Gastroenterology, Department of Internal Medicine, University of 
      Genoa, Genoa, Italy.
FAU - Savarino, Edoardo
AU  - Savarino E
AD  - Division of Gastroenterology, Department of Surgery, Oncology and 
      Gastroenterology, University of Padua, Padua, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160530
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Bacterial Infections/etiology
MH  - Drug-Related Side Effects and Adverse Reactions/*epidemiology
MH  - Gastroesophageal Reflux/*drug therapy
MH  - Hip Fractures/etiology
MH  - Histamine H2 Antagonists/*therapeutic use
MH  - Humans
MH  - Malnutrition/etiology
MH  - Myocardial Ischemia/etiology
MH  - Pneumonia/etiology
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Renal Insufficiency, Chronic/etiology
MH  - Vitamin B 12 Deficiency/etiology
OTO - NOTNLM
OT  - Adverse events
OT  - GERD
OT  - Gastro-oesophageal reflux disease
OT  - H2-receptor antagonists
OT  - PPI
EDAT- 2016/06/21 06:00
MHDA- 2017/06/16 06:00
CRDT- 2016/06/21 06:00
PHST- 2016/04/27 00:00 [received]
PHST- 2016/05/20 00:00 [revised]
PHST- 2016/05/23 00:00 [accepted]
PHST- 2016/06/21 06:00 [entrez]
PHST- 2016/06/21 06:00 [pubmed]
PHST- 2017/06/16 06:00 [medline]
AID - S1590-8658(16)30435-2 [pii]
AID - 10.1016/j.dld.2016.05.018 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2016 Aug;48(8):851-9. doi: 10.1016/j.dld.2016.05.018. Epub 2016 
      May 30.