Proton pump inhibitors and risk of all-cause and cause-specific mortality: A cohort study
| Autor: | Stephen J. W. Evans, Krishnan Bhaskaran, Liam Smeeth, John Tazare, Laurie A. Tomlinson, Elizabeth A. Williamson, Kathryn E. Mansfield, Ian J. Douglas, Jeremy P Brown, Kevin Wing |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
030226 pharmacology & pharmacy Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Cause of Death Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Lung cancer H2 receptor antagonist Pharmacology business.industry Proportional hazards model Confounding Hazard ratio Proton Pump Inhibitors medicine.disease mortality Confidence interval Histamine H2 Antagonists Propensity score matching Observational study proton pump inhibitors business Cohort study |
| Zdroj: | Brown, J P, Tazare, J R, Williamson, E, Mansfield, K E, Evans, S J, Tomlinson, L A, Bhaskaran, K, Smeeth, L, Wing, K & Douglas, I J 2021, ' Proton pump inhibitors and risk of all-cause and cause-specific mortality : A cohort study ', British Journal of Clinical Pharmacology, vol. 87, no. 8, pp. 3150-3161 . https://doi.org/10.1111/bcp.14728 |
| ISSN: | 0306-5251 |
| Popis: | Aim: To investigate the association between proton pump inhibitors (PPIs) and both all-cause and cause-specific mortality. Methods: We conducted a cohort study using the UK Clinical Practice Research Datalink GOLD database. We compared 733 885 new users of PPIs to 124 410 new users of H2 receptor antagonists (H2Ras). In a secondary analysis we compared 689 602 PPI new users to 1 361 245 nonusers of acid suppression therapy matched on age, sex and calendar year. Hazard ratios for all-cause and cause-specific mortality were estimated using propensity score (PS) weighted Cox models. Results: PPI prescription was associated with increased risk of all-cause mortality, with hazard ratios decreasing considerably by increasing adjustment (unadjusted hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.62-1.69; PS-weighted HR 1.38, 95% CI 1.33-1.44; high-dimensional PS-weighted HR 1.31, 95% CI 1.26-1.37). Short-term associations were observed with mortality from causes where a causal short-term association is unexpected (eg, lung cancer mortality: PS-weighted HR at 6 months 1.77, 95% CI 1.39-2.25). Adjusted hazard ratios were substantially higher when compared to nonusers (PS-weighted HR all-cause mortality 1.96, 95% CI 1.94-1.99) rather than H2RA users. Conclusions: PPI prescription was strongly associated with all-cause and cause-specific mortality. However, the change in hazard ratios (a) by increasing adjustment and (b) between comparator groups indicates that residual confounding is likely to explain the association between poor health outcomes and PPI use, and fully accounting for this using observational data may not be possible. |
| Databáze: | OpenAIRE |
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