Another group of researchers have found compelling evidence of a link between long-term use of proton pump inhibitors (PPIs) and serious, even deadly side effects. This most recent study, appearing in the British Medical Journal, indicates that patients who use popular heartburn medications such as Nexium and Prilosec over an extended period of time run a significantly increased risk of cardiovascular and chronic kidney disease and cancer of the upper gastrointestinal tract.
These effects were most frequently seen in patients who took PPIs without a clear medical reason over a period of several months or years – even in small doses.
The study, led by Dr. Ziyad Al-Aly of the Washington University School of Medicine in St. Louis, was based on an analysis of medical records obtained from the U.S. Department of Veterans Affairs. The research team examined over 214,000 patient records from 2002-2004; approximately three-quarters of the patients had been prescribed PPIs, while the remainder had regularly taken H2 receptor blockers such as Pepcid and Zantac. Over the course of ten years, they found 17 percent increase in the mortality rates among the group taking PPIs in comparison with those prescribed H2 receptor blockers.
Among the PPI group, approximately 39 percent of deaths were attributed to cardiovascular disease; nearly 29 percent died from stomach cancer. Another 14 percent died from chronic kidney disease, while the remainder succumbed to infections and parasitic infestations. Confirming what previous research has discovered, these risks increase the longer the medications are used.
In a BMJ blog, the authors of the study wrote, “The totality of the results suggests the need to avoid proton pump inhibitors when not medically indicated; for those who have a medical indication for proton pump inhibitors, use should be limited to the lowest effective dose and shortest duration possible. Al-Aly, who has conducted other studies on the effects of PPIs in the past, warns that patients should not take PPIs for more than two weeks. In a press release, he said that anyone feeling the need for over-the-counter PPIs for longer than 14 days should consult with a physician before continuing.
Al-Aly adds, “PPIs sold over the-counter should have a clearer warning about potential for significant health risks, as well as a clearer warning about the need to limit length of use.” Currently, there are no clear warnings on these products about the risks of long-term use of PPIs; however, the University of Washington reports that the U.S. Food and Drug Administration has begun to take notice of Al-Aly’s extensive research on this class of prescription medications – so stronger label warnings may be in the near future.