Adverse outcomes of long-term use of proton pump inhibitors: a systematic review and meta-analysis
Abstract
The association between the long-term use of proton pump inhibitors (PPIs) and the risks of various diseases remains controversial. Therefore, the primary objective of this study was to quantify the associations as presented in the literature and to also provide this information to healthcare professionals and patients about their potentially adverse effects. In July 2016, we searched through Medline (PubMed), Embase, and the Cochrane Library from inception using common keywords. We included observational studies that provided risk estimates on the long-term use of PPIs and their adverse effects. Overall, 43 studies were included in the systematic review, of which 28 studies were also included in the random effect meta-analysis. Odds of community-acquired pneumonia, hip fracture, and colorectal cancer were 67% [odds ratio (OR)=1.67; 95% confidence interval (CI): 1.04–2.67], 42% (OR=1.42; 95% CI: 1.33–1.53), and 55% (OR=1.55; 95% CI: 0.88–2.73) higher in patients with long-term PPIs use compared with patients who did not use PPIs. Although the use of PPIs provides short-term health benefits, their prolonged use is associated with minor and also potentially major adverse health outcomes. Hence, we strongly recommend that the prescription of PPIs should be done with caution to improve the medication’s efficacy and patients’ safety.
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Long-term use of PPIs exposes patients to an increased risk of developing extra-intestinal disorders.
“The use of PPIs is generally well tolerated, although their long-term use exposes patients to an increased risk of developing extra-intestinal disorders[6-8]”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [6]
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Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified
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- Authors
- Islam, M. M., Poly, T. N., Walther, B. A., Dubey, N. K., Anggraini Ningrum, D. N., Shabbir, S.-A., & (Jack) Li, Y.-C.
- Affiliations
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology
- Master Program in Global Health and Development, College of Public Health
- Taipei Medical University (TW)
- Venue
- European Journal of Gastroenterology & Hepatology
- Published
- 2018-12
- Volume
- 30
- Issue
- 12
- Pages
- 1395-1405
- ISSN
- 0954-691X (ISSN-L)
- OpenAlex
- W2884656050
- Cited by
- 88
- References
- 128
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 9 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 18 · 2019: 6 · 2018: 8
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Keywords
- proton pump inhibitors, long-term drug use, adverse drug reactions, community-acquired pneumonia, hip fracture, colorectal cancer, drug safety, risk estimates
- MeSH terms
- Hip Fractures, Humans, Pneumonia, Colorectal Neoplasms, Community-Acquired Infections, Risk Assessment, Proton Pump Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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