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Common reflux drug linked to early death

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Concern has been raised over the frequent prescription of a common medication to treat heartburn and reflux.

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A US longitudinal observational study published in medical journal BMJ Open has linked Proton pump inhibitors (PPIs) to a greater risk of premature death.

PPIs reduce the amount of acid made by the stomach and are one of the most widely prescribed medications in Australia.

A team of researchers analysed the data of more than six million people obtained from the US Department of Veterans Affairs to compare the risk of death among those using PPIs or H2 blockers.

The health of participants was tracked for almost six years until 2013 or death, which ever came first.

Those taking PPIs had a 25 per cent increased likelihood of death within a six year period compared to those taking H2 blockers, according to the findings.

This risk increased the longer someone took PPIs, according to the study published in journal BMJ Open.

While far from conclusive, the researchers say the “compelling” findings add to a growing body of evidence showing a “host of adverse events” associated with PPI use.

“Exercising pharmacovigilance and limiting PPI use to instances and durations where it is medically indicated may be warranted,” the authors wrote.

Gastroenterologist and Conjoint Professor Anne Duggan at the University of Newcastle’s School of Medicine and Public health agrees.

“This is a very good study but an observational study,” she said.

There could also be many other risk factors responsible for the risk of early death, such as being overweight, Duggan acknowledged.

But, she says, it has again left a “question mark” over the use of PPIs.

Recent research has indicated a link between PPI use and a heightened risk of chronic kidney disease, dementia and bone fracture in people with osteoporosis.

There’s also been a lot of studies questioning whether PPIs lead to increased infections, says Duggan.

In fact, the long term use of PPIs is one of five drugs a recent NPS MedicineWise campaign warned against.

“We should always be using drugs sensibly, the right drug, the right dose and we should be de-prescribing much more than we do,” Duggan said.

“There is a real problem in Australia in people being put on it for a bit reflux and then everyone forgets about it and just keeps writing the scripts.”

Duggan says all drugs have side effects and has called for a focus on lifestyle changes to reduce the incidence of heartburn.

“One of the biggest risk factors for acid reflux is obesity, smoking,” she said.

“If you really want to provide healthcare rather than sickcare then you’d be working to try to reduce their risk factors and we do know that for many people if they loose weight their reflux goes away.”

– AAP

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