Popular heartburn medications like Nexium, Prilosec or Prevacid may increase your risk of early death when taken for extended periods.
Proton pump inhibitors (PPIs), the greater your risk of early death, said senior researcher Dr. Ziyad Al-Aly from Washington University School of Medicine. There was a relationship between duration of use and risk of death.
The study found that people taking PPIs for a year or more had a 51 percent increased risk of premature death, compared with 31 percent for people on the drugs for six months to a year, and 17 percent for three- to six-month users. Short-term use of PPIs up to 90 days did not appear to affect death risk.
Proton pump inhibitors work by blocking the enzyme system that produces stomach acid. PPIs have become one of the most commonly used classes of drugs in the United States, with 15 million monthly prescriptions in 2015 for Nexium alone.
However, concerns about the drug’s safety have been growing in recent years, as studies have linked PPIs to kidney disease, heart disease, pneumonia, bone fractures and dementia.
Nearly 276,000 users of PPIs against those of about 73,000 people who took another class of heartburn drug called H2 blockers. Overall, PPI users have a 25 percent increased risk of premature death compared with people taking H2 blockers.
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The researchers calculated that for every 500 people taking PPIs for a year, there is one extra death that would not have occurred otherwise.
This finding is certainly cause for concern and something that should be considered as doctors continue to prescribe PPIs at a high rate and often fail to discontinue these drugs in a timely fashion.
At the same time, people taking PPIs also tend to have many other health problems, and these might influence their risk of death as well.
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No one is sure why PPIs might cause all these health problems or increase risk of early death. It is possible the drugs might cause cellular or genetic damage.
Even though this study could not prove a direct cause-and-effect relationship that the increased risk with longer duration adds weight to concerns over the drugs’ safety. Recommended treatment regimens for most PPIs are relatively short, the researchers said.
If people find themselves taking proton pump inhibitors for an extended period of time with no valid need for doing so, or for symptoms that can be managed in other ways, that’s when there’s far more risk than any potential benefit.
Cohen said that “there is little question that the short-term use of PPIs for many conditions can be beneficial to patients.”
The challenge to physicians should remain to use medications judiciously and continue to assess the benefit of a medication to a patient over time.