Reflux diagnosis encourages overtreatment
DIAGNOSING babies with reflux increases parents’ desire to medicate them, even when parents are told reflux medications are ineffective, research shows.
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Proton Pump Inhibitors
The following articles have the tag Proton Pump Inhibitors
Long-term PPI use increases hip fractures post menopause
POSTMENOPAUSAL women using proton pump inhibitors (PPIs) long-term have an increased risk of hip fracture, a large study shows.
Low magnesium link to PPIs prompts safety update
THE TGA has issued a medicines safety update for PPIs, warning of the risk to patients of hypomagnesaemia and other life-threatening events, pointing to an advisory released by the US Food and Drug Administration in March. “A recent international safety advisory has warned of a potential association between prolonged use of PPIs and serious hypomagnesaemia-related adverse events such as tetany, seizures, delirium and cardiac arrhythmias,” the TGA said. “While this occurs rarely, prescribers should be vigilant to PPI-associated hypomagnesaemia [and] patients presenting with hypomagnesaemia may require PPI discontinuation.” Two Australian cases of low magnesium levels linked ...
Inappropriate PPI use needs closer monitoring and review
AUSTRALIAN gastroenterologists are warning that overprescribing and incorrect use of proton pump inhibitors (PPIs) are becoming increasingly common, posing unnecessary risks for patients. The warning comes as new evidence emerged on the association between PPI use and a range of adverse events. Among these was a study finding long-term PPI use was associated with a 47% increased risk of clinical spine fractures, a 26% increased risk of arm or wrist fracture and a 25% increased risk of total fracture. Another study found patients using PPIs and concurrent treatment for Clostridium difficile infection had a 42% greater ...
PPI-clopidogrel death risk fear ‘premature’
DRUG regulatory authorities may have over-reacted in warning about the safety of concomitant use of proton pump inhibitors and clopidogrel use, a leading specialist says. Gastroenterological Society of Australia council member Associate Professor Geoff Hebbard said a recent meta-analysis showing no overall increased mortality in patients on PPI plus clopidogrel was reassuring. Researchers from the Univers-ity of East Anglia in the UK reviewed 23 studies covering more than 93,000 patients, finding pooled estimates that suggested clopidogrel/PPI use might be associated with adverse cardiovascular events and myocardial infarction, but no statistically significant all-cause mortality rise. ...
Stepping down with PPIs
MANY patients using proton pump inhibitors (PPIs) may not need to continue therapy long term. After initial PPI treatment, guidelines recommend a step-down approach. This includes reducing from double dose to standard dose, and from standard dose to low dose, as well as reviewing the need for ongoing therapy. While PPIs are widely regarded as safe medicines, evidence suggests they can cause serious adverse effects. Acute interstitial nephritis, a rare hypersensitivity reaction, has been reported and recent studies have also indicated that PPIs may increase the risk of Clostridium difficile infection and community-acquired pneumonia. ...
PPI audit to target prescribing
WITH a number of recent studies highlighting potentially serious adverse events associated with the use of proton pump inhibitors (PPIs), the National Prescribing Service (NPS) has begun moves to reduce high-dose prescribing. The NPS is launching a new clinical e-audit for GPs to review their PPI prescribing practices and already 1700 GPs have agreed to participate. According to Judith Mackson, senior adviser for quality use of medicines at the NPS, the main issue with PPIs was that there were patients who could be managed with lower doses as part of maintenance therapy. “There’s [also] a small ...
Study implicates PPIs in onset of reflux
PROTON-pump inhibitors (PPIs), currently used by approximately 5% of people in the developed world, may actually induce the acid-related symptoms they are used to treat, new research claims. Danish researchers randomised 120 healthy young volunteers without acid disease to receive esomeprazole (Nexium) for eight weeks followed by four weeks of placebo or receive 12 weeks of placebo. In weeks 9-12 of the trial, clinically significant symptoms of heartburn, acid reflux or dyspepsia were reported by 44% of those in the treatment group, compared to 15% of the placebo cohort. “We believe that our findings [are] a ...
PPI fracture risk warning
CLINICIANS should consider the possibility of increased fracture risk when prescribing proton pump inhibitors (PPIs), according to the latest bulletin from the Adverse Drug Reactions Advisory Committee (ADRAC). Clinicians are advised to prescribe the lowest effective dose and to periodically assess patients to determine whether PPI therapy remained appropriate. The warning follows three large retrospective studies that suggested an association between PPIs and an increased incidence of fracture. However, ADRAC said it had received only two reports of adverse events linking PPIs with a pathological fracture and/or osteoporosis. The PPI was the sole suspect in ...
New concerns raised over proton pump inhibitor interactions
ANOTHER study has raised questions about the widespread acceptance and safety of long-term proton pump inhibitor (PPI) use. The latest research has found PPIs may interfere with the antiplatelet effect of clopidogrel, leading to an increased risk of recurrent myocardial infarction. The findings add to previous evidence linking these acid suppression drugs with osteoporotic fracture and pneumonia. The effect of PPIs on clopidogrel may account for thousands of hospital readmissions annually, authors of a Canadian study said after linking concurrent prescription to a 40% increased risk of reinfarction. The researchers found that PPIs such as ...
Bone risk significant with seven years of PPI therapy
PATIENTS using proton pump inhibitors (PPIs) for more than five years have a greatly increased risk of osteoporotic fractures, leading Australian experts to recommend all long-term users undergo bone density tests. While previous studies have indicated a link between PPIs and fracture risk, a Canadian case-controlled study involving more than 63,000 patients has now given a time frame for the incidence of risk. Five or more years’ continuous PPI use was linked to an increased risk of hip fracture, and magnitude increased with duration of exposure. Seven or more years use was associated with significantly increased ...