Popular Heartburn Drugs Linked to Increased Risk of Early Death
Heartburn—also known as acid reflux—is a very common complaint, usually considered to be relatively minor. If you are like most people, you have probably experienced this uncomfortable condition at one time during your life. Heartburn is the result of stomach acid seeping up into the esophagus, and can be triggered by a number of different things, including consumption of certain foods, obesity, pregnancy, or lying down immediately after eating.
What the science says about PPIs and risk of early death
According to a new study published in the journal BMJ Open , a strong association has been found between the use of a certain class of anti-heartburn drugs and early death.
— Ziyad Al-Aly (@zalaly) July 5, 2017
The class of drugs in question here are called Proton Pump Inhibitors (PPIs), and include prescription and over-the-counter brand names such as Nexium (esomeprazole) and Prevacid (lansoprazole). PPIs are among the most commonly used drugs in the United States, accounting for approximately $10 billion in annual sales.
Previous studies have linked long-term use of PPIs to a variety of health problems, including bone fractures, dementia, nutrient deficiencies, pneumonia, and kidney damage, but this study was the first of its kind to examine an increased risk for early death related to these individual factors, or a combination thereof.
The study examined the records of nearly 350,000 patients from the U.S. Veterans Affairs database who had been prescribed medication for heartburn. They tracked outcomes over eight years, comparing patients who were prescribed PPIs with patients who were prescribed a different class of heartburn medications, called Histamine-2 (H2) blockers, including Pepcid (famotidine) and Zantac (ranitidine). Researchers found that those patients who were prescribed PPIs did indeed have a 25% higher risk of dying during the study period as compared to the patients prescribed H2 blockers, and a 23% higher risk of dying during the study than people who took no medications at all for heartburn relief.
Conclusion: Use of PPIs is linked to early death
The researchers stress that this study was observational only, and are “far from conclusive”, meaning that they do not at this time prove cause and effect. The research did conclude, however, that the longer a patient was using PPIs, the higher their risk of early death. PPIs sold over-the-counter have the same chemical makeup as their prescription counterparts, only at lower concentrations, and there is no way to know how long people stay on them. The Food and Drug Administration currently recommends use of PPIs no longer than 4-weeks, and then consulting a doctor.
There are times when a PPI is absolutely the best clinical choice for management of certain medical conditions, but physicians should be monitoring their patients carefully for complications, and seeking less risky alternatives for treating heartburn whenever possible.