PPIs or Proton Pump Inhibitors are one of the top 10 selling generic drugs in the United States. They’re used to treat heartburn and acid reflux by suppressing acid production in the patients stomach. But a study conducted last year showed that this drug may have unintended complications. A revised article documenting this study was just recently posted here.
Specifically, this study revealed that when used long-term, a patients risk of developing stomach cancer increases by around 250%.
Researchers identified 63,397 patients who received a combination of a PPI and two different antibiotics to treat a Helicobacter pylori infection. This type of bacteria is naturally carried in half of the population but for a small number of people, it can cause stomach cancer. Researchers make it clear that in most cases PPIs are an effective and important treatment for this bacteria. It is only with longterm use that some patients have developed problems.
In this specific study, patients were observed for 7 and a half years. 3,271 of the patients took PPIs for three years and 21,729 took H2 blockers instead. In total, 153 of the patients in the study developed stomach cancer, but those who took PPIs showed to be 2.44 times more likely to develop the disease.
These findings were strongly correlated with the length of PPI use. When PPIs were used daily, the risk was 4.55 higher than baseline and when it was taken for three years or more that risk became 8-fold.
It is important to note that this was only an observational study. However, it does clearly show that more research is needed to determine risk associated with PPIs.
It is also important to note that investigators only saw correlation between PPIs and cancer. They did not see a correlation with any other type of anti-suppressive drug. This indicates that it is most likely not the acid-suppression from PPIs which leads to heightened risk.
What it all means
The risk showed in this observational study was low overall. There are 10,000 people diagnosed with stomach cancer each year, and a diagnosis from PPI use is only predicted to add an additional four cases.
Some researchers believe that the risk associated with longterm use can be attributed to the fact that people who take PPIs longterm are generally suffering from multiple conditions which make them more susceptible than individuals who only take it for a short period of time.
This study (and it’s not the only one of its kind) shows that we need to more deeply examine the risk associated with PPIs and why it is amplified when used longterm.
The full findings of this study were reported in Gut.
You can read also read more about this study and its implications here.