-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Read only for medical professionals.
Long-term use of PPIs increases the risk of gastrointestinal cancer! Acid-suppressing drugs, including proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs), are commonly used to treat a variety of gastrointestinal disorders
.
In recent years, PPIs have been increasingly recognized in clinical practice due to their excellent acid-suppressing ability and safety
.
However, is this really the case? Studies have shown that long-term use of PPIs may be associated with adverse gastrointestinal outcomes, such as Clostridium difficile infection, intestinal colonization by multidrug-resistant bacteria, and gastric cancer
.
In order to explore the relationship between PPI and gastrointestinal cancer, Professor Devin Abrahami from Canada conducted a clinical study, which was recently published in GUT, an authoritative journal of the gastrointestinal tract
.
Figure 1: Screenshot of the study based on the million-person study confirming that PPIs are associated with an increased risk of gastric cancer.
This study used UK Clinical Practice Research Data (CPRD), a population-based retrospective cohort study of 973,281 subjects using PPIs.
and 198,306 subjects using H2RA and followed up for up to 28 years until subjects were diagnosed with gastric cancer, switched drugs, died, or at the end of follow-up (April 2019)
.
The HR and 95% CI of gastric cancer were estimated by Cox proportional hazards model, and the number of gastric cancer patients was estimated using the Kaplan-Meier method
.
As well as weighting the model using standardized mortality weights and calendar-time-specific propensity scores
.
After analysis, the researchers came to three major conclusions: 1.
PPI can lead to an increase in the relative risk of gastric cancer, up to 45% in 5 years.
The results of the study showed that after a median follow-up of 5.
0 years, compared with the use of H2RA, PPI could lead to an increased risk of gastric cancer.
45% (HR 1.
45, 95% CI 1.
06-1.
98)
.
Figure 2: Relationship between H2RA and PPI and the risk of gastric cancer, IR: incidence; NNH: number of cases, and the cumulative incidence of gastric cancer caused by PPI was consistently higher than that of H2RA, and the weighted cumulative incidence of gastric cancer was divergent after two years of follow-up (Figure 3).
shown)
.
Figure 3: Weighted Kaplan-Meier curves showing cumulative incidence of gastric cancer with PPI and H2RA
.
Curves were weighted using standardized mortality weights, with a weight of 1 for PPI patients.
2.
Gastric cancer risk increased with duration of PPI use and cumulative dose.
In addition, secondary analyses were performed to assess cumulative duration of PPI use and cumulative dose.
relationship with gastric cancer
.
Compared with the use of H2RA, the risk of gastric cancer will also increase with the increase of the cumulative duration of PPI use (as shown in Figure 4)
.
Figure 4: Compared with H2RA, the relationship between the duration of PPI use, the cumulative dose of omeprazole, the time of initial treatment of PPI use and the risk of gastric cancer The daily dose (shown in Figure 5), converts the doses of different types of PPI drugs into doses of omeprazole
.
The trial results showed that, compared with the use of H2RA, as the cumulative dose of omeprazole increased, the risk of gastric cancer would also increase
.
Figure 5: The daily dose of PPI defined by WHO Three, different types of PPI drugs can increase the risk of gastric cancer.
In addition, the study also found that compared with H2RA, esomeprazole can increase the risk of gastric cancer by 25%, blue Soprazole increased the risk of gastric cancer by 48%, omeprazole increased the risk of gastric cancer by 45%, pantoprazole increased the risk of gastric cancer by 19%, and rabeprazole increased the risk of gastric cancer by 44%
.
Figure 6: Risk relationship of different PPIs on gastric cancer compared with H2RA In summary, it can be concluded that PPI can lead to an increased risk of gastric cancer, and with the increase of the cumulative duration and cumulative dose of PPI, the risk of gastric cancer also increases
.
However, the absolute risk of gastric cancer from PPIs remains low, and the need for continued therapy should be assessed when PPI therapy is necessary
.
PPIs are not only associated with an increased risk of gastric cancer, but are also associated with an increased risk of colorectal cancer? Professor Devin Abrahami studied not only the correlation between PPI and gastric cancer risk, but also the correlation between PPI and colorectal cancer risk
.
A large population-based cohort study assessed whether PPIs increase the risk of colorectal cancer compared with H2RA
.
1,293,749 subjects using PPIs and 292,387 subjects using H2RA were included and followed for up to 28 years until subjects were diagnosed with colorectal cancer, switched drugs, died, or at the end of follow-up (April 2019).
)
.
Results showed that while PPI use was not associated with increased overall risk of colorectal cancer (HR 1.
02, 95% CI 0.
92-1.
14), overall colorectal cancer risk increased with cumulative duration of PPI use (<2 years, HR 0.
93 , 95%CI 0.
83-1.
04; 2-4 years, HR 1.
45, 95%CI 1.
28-1.
60; ≥4 years, HR: 1.
60, 95%CI 1.
42-1.
80)
.
Figure 7: Association between PPI use and colorectal cancer compared to H2RA
.
IR: incidence rate; NNH: number of people affected Although the use of any PPI was not associated with an increased risk of colorectal cancer compared with H2RA, long-term use of PPIs may increase the risk of colorectal cancer and thus lead to an increase in the number of people who develop colorectal cancer
.
Given this risk, PPIs should be discontinued in patients who no longer require treatment, and physicians should closely monitor patients requiring long-term PPI therapy
.
Therefore, when using PPI therapy, it is necessary to pay attention to the risk of long-term safety of PPI, to shorten the use time of PPI as much as possible, or to combine medication to reduce the dosage of PPI, so as to reduce or avoid serious adverse reactions caused by PPI
.
References: [1] Devin Abrahami, Emily Gibson McDonald et al.
Proton pump inhibitors and risk of gastric cancer: population-based cohort study.
Gut 2022.
Epub 2021 Jul 5.
https://gut.
bmj.
com/content/ 71/1/16.
long[2] Devin Abrahami, Emily Gibson McDonald et al.
Proton pump inhibitors and risk of colorectal cancer.
Gut.
2022.
Epub 2021 Jul 1.
https://gut.
bmj.
com/content/71 /1/111.
long
Long-term use of PPIs increases the risk of gastrointestinal cancer! Acid-suppressing drugs, including proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs), are commonly used to treat a variety of gastrointestinal disorders
.
In recent years, PPIs have been increasingly recognized in clinical practice due to their excellent acid-suppressing ability and safety
.
However, is this really the case? Studies have shown that long-term use of PPIs may be associated with adverse gastrointestinal outcomes, such as Clostridium difficile infection, intestinal colonization by multidrug-resistant bacteria, and gastric cancer
.
In order to explore the relationship between PPI and gastrointestinal cancer, Professor Devin Abrahami from Canada conducted a clinical study, which was recently published in GUT, an authoritative journal of the gastrointestinal tract
.
Figure 1: Screenshot of the study based on the million-person study confirming that PPIs are associated with an increased risk of gastric cancer.
This study used UK Clinical Practice Research Data (CPRD), a population-based retrospective cohort study of 973,281 subjects using PPIs.
and 198,306 subjects using H2RA and followed up for up to 28 years until subjects were diagnosed with gastric cancer, switched drugs, died, or at the end of follow-up (April 2019)
.
The HR and 95% CI of gastric cancer were estimated by Cox proportional hazards model, and the number of gastric cancer patients was estimated using the Kaplan-Meier method
.
As well as weighting the model using standardized mortality weights and calendar-time-specific propensity scores
.
After analysis, the researchers came to three major conclusions: 1.
PPI can lead to an increase in the relative risk of gastric cancer, up to 45% in 5 years.
The results of the study showed that after a median follow-up of 5.
0 years, compared with the use of H2RA, PPI could lead to an increased risk of gastric cancer.
45% (HR 1.
45, 95% CI 1.
06-1.
98)
.
Figure 2: Relationship between H2RA and PPI and the risk of gastric cancer, IR: incidence; NNH: number of cases, and the cumulative incidence of gastric cancer caused by PPI was consistently higher than that of H2RA, and the weighted cumulative incidence of gastric cancer was divergent after two years of follow-up (Figure 3).
shown)
.
Figure 3: Weighted Kaplan-Meier curves showing cumulative incidence of gastric cancer with PPI and H2RA
.
Curves were weighted using standardized mortality weights, with a weight of 1 for PPI patients.
2.
Gastric cancer risk increased with duration of PPI use and cumulative dose.
In addition, secondary analyses were performed to assess cumulative duration of PPI use and cumulative dose.
relationship with gastric cancer
.
Compared with the use of H2RA, the risk of gastric cancer will also increase with the increase of the cumulative duration of PPI use (as shown in Figure 4)
.
Figure 4: Compared with H2RA, the relationship between the duration of PPI use, the cumulative dose of omeprazole, the time of initial treatment of PPI use and the risk of gastric cancer The daily dose (shown in Figure 5), converts the doses of different types of PPI drugs into doses of omeprazole
.
The trial results showed that, compared with the use of H2RA, as the cumulative dose of omeprazole increased, the risk of gastric cancer would also increase
.
Figure 5: The daily dose of PPI defined by WHO Three, different types of PPI drugs can increase the risk of gastric cancer.
In addition, the study also found that compared with H2RA, esomeprazole can increase the risk of gastric cancer by 25%, blue Soprazole increased the risk of gastric cancer by 48%, omeprazole increased the risk of gastric cancer by 45%, pantoprazole increased the risk of gastric cancer by 19%, and rabeprazole increased the risk of gastric cancer by 44%
.
Figure 6: Risk relationship of different PPIs on gastric cancer compared with H2RA In summary, it can be concluded that PPI can lead to an increased risk of gastric cancer, and with the increase of the cumulative duration and cumulative dose of PPI, the risk of gastric cancer also increases
.
However, the absolute risk of gastric cancer from PPIs remains low, and the need for continued therapy should be assessed when PPI therapy is necessary
.
PPIs are not only associated with an increased risk of gastric cancer, but are also associated with an increased risk of colorectal cancer? Professor Devin Abrahami studied not only the correlation between PPI and gastric cancer risk, but also the correlation between PPI and colorectal cancer risk
.
A large population-based cohort study assessed whether PPIs increase the risk of colorectal cancer compared with H2RA
.
1,293,749 subjects using PPIs and 292,387 subjects using H2RA were included and followed for up to 28 years until subjects were diagnosed with colorectal cancer, switched drugs, died, or at the end of follow-up (April 2019).
)
.
Results showed that while PPI use was not associated with increased overall risk of colorectal cancer (HR 1.
02, 95% CI 0.
92-1.
14), overall colorectal cancer risk increased with cumulative duration of PPI use (<2 years, HR 0.
93 , 95%CI 0.
83-1.
04; 2-4 years, HR 1.
45, 95%CI 1.
28-1.
60; ≥4 years, HR: 1.
60, 95%CI 1.
42-1.
80)
.
Figure 7: Association between PPI use and colorectal cancer compared to H2RA
.
IR: incidence rate; NNH: number of people affected Although the use of any PPI was not associated with an increased risk of colorectal cancer compared with H2RA, long-term use of PPIs may increase the risk of colorectal cancer and thus lead to an increase in the number of people who develop colorectal cancer
.
Given this risk, PPIs should be discontinued in patients who no longer require treatment, and physicians should closely monitor patients requiring long-term PPI therapy
.
Therefore, when using PPI therapy, it is necessary to pay attention to the risk of long-term safety of PPI, to shorten the use time of PPI as much as possible, or to combine medication to reduce the dosage of PPI, so as to reduce or avoid serious adverse reactions caused by PPI
.
References: [1] Devin Abrahami, Emily Gibson McDonald et al.
Proton pump inhibitors and risk of gastric cancer: population-based cohort study.
Gut 2022.
Epub 2021 Jul 5.
https://gut.
bmj.
com/content/ 71/1/16.
long[2] Devin Abrahami, Emily Gibson McDonald et al.
Proton pump inhibitors and risk of colorectal cancer.
Gut.
2022.
Epub 2021 Jul 1.
https://gut.
bmj.
com/content/71 /1/111.
long
