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Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis.
Wong, Zhen Yu; Koh, Jia Hong; Muthiah, Mark; Koh, Benjamin; Ong, Elden Yen Hng; Ong, Christen En Ya; Ou, Kai Qi; Lim, Wen Hui; Tan, Darren Jun Hao; Chee, Douglas; Siah, Kewin Tien Ho; Wong, Yujun; Kaewdech, Apichat; Wijarnpreecha, Karn; Kulkarni, Anand V; Nah, Benjamin; Huang, Daniel Q; Noureddin, Mazen; Ng, Cheng Han; Teng, Margaret.
Afiliación
  • Wong ZY; Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Koh JH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Muthiah M; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Koh B; National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore.
  • Ong EYH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Ong CEY; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Ou KQ; National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore.
  • Lim WH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Tan DJH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Chee D; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Siah KTH; Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Wong Y; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Kaewdech A; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Wijarnpreecha K; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Kulkarni AV; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Nah B; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
  • Huang DQ; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Noureddin M; Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
  • Ng CH; Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
  • Teng M; Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
Dig Dis Sci ; 69(1): 289-297, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37968557
BACKGROUND/AIMS: Proton pump inhibitors (PPIs) are frequently prescribed to cirrhotic patients, but there is limited longitudinal evidence regarding their effects. This study aimed to assess the impact of PPIs on adverse events in cirrhotic patients. METHODS: A comprehensive search was conducted using the Medline and Embase databases to identify relevant articles. Pooled hazard ratios (HRs) using DerSimonian and Laird random-effects model were calculated to evaluate the risk of adverse events such as long-term mortality, hepatic decompensation, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and overall infection in cirrhotic patients with PPI use. RESULTS: The analysis included 28 studies with 260,854 cirrhotic patients. The prevalence of PPI use among cirrhotic patients was 55.93%. The use of PPIs was not significantly associated with short-term mortality in cirrhotic patients. However, long-term mortality (HR 1.321, 95% CI 1.103-1.581, P = 0.002), decompensation (HR 1.646, 95% CI 1.477-1.835, P < 0.001), HE (HR 1.968, 95% CI 1.372-2.822, P < 0.001), SBP (HR 1.751, 95% CI 1.649-1.859, P < 0.001), and infection (HR 1.370, 95% CI 1.148-1.634, P < 0.001) were significantly associated with PPI use. Sensitivity analysis with prospective studies yielded similar results. CONCLUSION: PPIs should be reserved for appropriate indications at lowest effective dose for cirrhotic patients due to the potential harm.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritonitis / Encefalopatía Hepática Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Dig Dis Sci Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritonitis / Encefalopatía Hepática Tipo de estudio: Systematic_reviews Límite: Humans Idioma: En Revista: Dig Dis Sci Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos