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Individualized prevention of proton pump inhibitor related adverse events by risk stratification

Author

Listed:
  • Bin Xia

    (Sun Yat-sen University
    Chinese Health RIsk MAnagement Collaboration (CHRIMAC))

  • Qiangsheng He

    (Sun Yat-sen University
    Chinese Health RIsk MAnagement Collaboration (CHRIMAC))

  • Fang Gao Smith

    (University of Birmingham
    University Hospitals Birmingham NHS Foundation Trust)

  • V. Georgios Gkoutos

    (University Hospitals Birmingham NHS Foundation Trust
    University of Birmingham
    University of Birmingham, Edgbaston)

  • Krishnarajah Nirantharakumar

    (University of Birmingham, Edgbaston
    University of Birmingham)

  • Zi Chong Kuo

    (Sun Yat-sen University)

  • Danni Wang

    (Sun Yat-sen University
    Chinese Health RIsk MAnagement Collaboration (CHRIMAC))

  • Qi Feng

    (University of Oxford)

  • Eddie C. Cheung

    (Sun Yat-sen University
    University of California)

  • Lunzhi Dai

    (Sichuan University)

  • Junjie Huang

    (The Chinese University of Hong Kong, Sha Tin)

  • Yuanyuan Yu

    (The Chinese University of Hong Kong, Sha Tin)

  • Wenbo Meng

    (The First Hospital of Lanzhou University)

  • Xiwen Qin

    (University of Western Australia
    Hong Kong Science Technology Park, Sha Tin)

  • Jinqiu Yuan

    (Sun Yat-sen University
    Chinese Health RIsk MAnagement Collaboration (CHRIMAC)
    Sun Yat-sen University)

Abstract

Proton pump inhibitors (PPIs) are commonly used for gastric acid-related disorders, but their safety profile and risk stratification for high-burden diseases need further investigation. Analyzing over 2 million participants from five prospective cohorts from the US, the UK, and China, we found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease, diabetes, respiratory infections, and chronic kidney disease. These associations showed dose-response relationships and consistency across different PPI types. PPI-related absolute risks increased with baseline risks, with approximately 82% of cases occurring in those at the upper 40% of the baseline predicted risk, and only 11.5% of cases occurring in individuals at the lower 50% of the baseline risk. While statistical association does not necessarily imply causation, its potential safety concerns suggest that personalized use of PPIs through risk stratification might guide appropriate decision-making for patients, clinicians, and the public.

Suggested Citation

  • Bin Xia & Qiangsheng He & Fang Gao Smith & V. Georgios Gkoutos & Krishnarajah Nirantharakumar & Zi Chong Kuo & Danni Wang & Qi Feng & Eddie C. Cheung & Lunzhi Dai & Junjie Huang & Yuanyuan Yu & Wenbo , 2024. "Individualized prevention of proton pump inhibitor related adverse events by risk stratification," Nature Communications, Nature, vol. 15(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-48007-8
    DOI: 10.1038/s41467-024-48007-8
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    References listed on IDEAS

    as
    1. Ya Qi Song & Yong Li & Su Li Zhang & Jie Gao & Shun Yi Feng, 2019. "Proton pump inhibitor use does not increase dementia and Alzheimer’s disease risk: An updated meta-analysis of published studies involving 642305 patients," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-9, July.
    2. Hsin-Ya Kuo & Chih-Sung Liang & Shih-Jen Tsai & Tzeng-Ji Chen & Che-Sheng Chu & Mu-Hong Chen, 2022. "Dose-Dependent Proton Pump Inhibitor Exposure and Risk of Type 2 Diabetes: A Nationwide Nested Case–Control Study," IJERPH, MDPI, vol. 19(14), pages 1-9, July.
    3. Bao, Y. & Bertoia, M.L. & Lenart, E.B. & Stampfer, M.J. & Willett, W.C. & Speizer, F.E. & Chavarro, J.E., 2016. "Origin, methods, and evolution of the three nurses' health studies," American Journal of Public Health, American Public Health Association, vol. 106(9), pages 1573-1581.
    4. Cristina Llorente & Peter Jepsen & Tatsuo Inamine & Lirui Wang & Sena Bluemel & Hui J. Wang & Rohit Loomba & Jasmohan S. Bajaj & Mitchell L. Schubert & Masoumeh Sikaroodi & Patrick M. Gillevet & Jun X, 2017. "Gastric acid suppression promotes alcoholic liver disease by inducing overgrowth of intestinal Enterococcus," Nature Communications, Nature, vol. 8(1), pages 1-15, December.
    5. Cristina Llorente & Peter Jepsen & Tatsuo Inamine & Lirui Wang & Sena Bluemel & Hui J. Wang & Rohit Loomba & Jasmohan S. Bajaj & Mitchell L. Schubert & Masoumeh Sikaroodi & Patrick M. Gillevet & Jun X, 2017. "Publisher Correction: Gastric acid suppression promotes alcoholic liver disease by inducing overgrowth of intestinal Enterococcus," Nature Communications, Nature, vol. 8(1), pages 1-1, December.
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