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Article Publish Status: FREE
Abstract Title:

Proton pump inhibitor use increases mortality and hepatic decompensation in liver cirrhosis.

Abstract Source:

World J Gastroenterol. 2019 Sep 7 ;25(33):4933-4944. PMID: 31543684

Abstract Author(s):

Marianne Anastasia De Roza, Lim Kai, Jia Wen Kam, Yiong Huak Chan, Andrew Kwek, Tiing Leong Ang, John Chen Hsiang

Article Affiliation:

Marianne Anastasia De Roza

Abstract:

BACKGROUND: Proton pump inhibitors (PPIs) are widely prescribed, often without clear indications. There are conflicting data on its association with mortality risk and hepatic decompensation in cirrhotic patients. Furthermore, PPI users and PPI exposure in some studies have been poorly defined with many confounding factors.

AIM: To examine if PPI use increases mortality and hepatic decompensation and the impact of cumulative PPI dose exposure.

METHODS: Data from patients with decompensated liver cirrhosis were extracted from a hospital database between 2013 to 2017. PPI users were defined as cumulative defined daily dose (cDDD)≥ 28 within a landmark period, after hospitalisation for hepatic decompensation. Cox regression analysis for comparison was done after propensity score adjustment. Further risk of hepatic decompensation was analysed by Poisson regression.

RESULTS: Among 295 decompensated cirrhosis patients, 238 were PPI users and 57 were non-users. PPI users had higher mortality compared to non-users [adjusted HR = 2.10, (1.20-3.67);= 0.009]. Longer PPI use with cDDD>90 was associated with higher mortality, compared to non-users [aHR = 2.27, (1.10-5.14);= 0.038]. PPI users had a higher incidence of hospitalization for hepatic decompensation [aRR = 1.61, (1.30-2.11);<0.001].

CONCLUSION: PPI use in decompensated cirrhosis is associated with increased risk of mortality and hepatic decompensation. Longer PPI exposure with cDDD>90 increases the risk of mortality.

Study Type : Human Study

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Sayer Ji
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