TOPLINE:
Observational data suggest an increased risk for cardiovascular (CV) events and all-cause mortality among older adults with diabetes who are exposed to proton pump inhibitors (PPIs).
METHODOLOGY:
- From administrative health databases in the Lombardy Region of Italy, a total of 284,068 adults aged ≥ 65 years with diabetes were identified, of whom 49.4% were prescribed PPIs in 2015 and 50.6% were not.
- A propensity score-matched analysis was conducted with n = 88,876 in each group.
TAKEAWAY:
- During a median follow-up of 6.7 years, those exposed to PPIs had significantly higher risks for ischaemic stroke (hazard ratio, 1.14; 95% CI, 1.08-1.20), myocardial infarction (1.36; 1.31-1.41), and total mortality (1.24; 1.22-1.26).
- The CV event and mortality risks remained increased across PPI types, with the highest mortality risk vs non-PPI users seen with omeprazole (1.26; 1.23-1.28).
- Significant associations were found between ischaemic stroke and PPIs among men (1.20; 1.12-1.29), people without prior CV disease history (1.14; 1.08-1.21), and those not using insulin (1.15; 1.08-1.22).
- The propensity score analysis confirmed the unmatched findings, with similar increased risks with PPIs for ischaemic stroke (1.12; 1.06-1.19), myocardial infarction (1.34; 1.28-1.40), and total mortality (1.19; 1.17-1.21).
IN PRACTICE:
“Although we recognized the known limitations of this observational study, our findings suggest that the harms of these drugs outweigh the benefits.”
SOURCE:
The study was conducted by Andreana Foresta, of the Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy, and colleagues and published online in Drugs & Aging.
LIMITATIONS:
Limitations included the study’s observational nature and potential residual confounding. Anthropomorphic, behavioural, and biochemical data were unavailable for adjustments, and there was no information on PPI indication.
DISCLOSURES:
This study was part of the EPIFARM-Pharmaco-epidemiology Agreement between the Istituto di Ricerche Farmacologiche Mario Negri IRCCS and the Lombardy region. The authors reported no conflicts of interest.
Source link : https://www.medscape.com/s/viewarticle/proton-pump-inhibitors-may-harm-older-adults-diabetes-2024a10003o8?src=rss
Author :
Publish date : 2024-02-27 14:00:00
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