JAMA links Rx PPI use to second disease state: dementia
WASHINGTON - For the second time in as many weeks, the Journal of the American Medical Association has published research linking the regular use of prescription proton pump inhibitors to an increased risk of disease. Last week it was chronic kidney disease; this week it's dementia.
According to an article in JAMA Neurology published Monday, the use of proton pump inhibitors, the medications used to treat gastroesophageal reflux and peptic ulcers, may be associated with an increased risk of dementia in a study using data from a large German health insurer.
Britta Haenisch, of the German Center for Neurodegenerative Diseases, Bonn, Germany, and coauthors examined the association between the use of PPIs and the risk of dementia using data from 2004 to 2011 on inpatient and outpatient diagnoses and drug prescriptions. Regular PPI use was at least one PPI prescription in each quarter of an 18-month interval.
The study population included 73,679 individuals included in the final analysis. The authors identified 29,510 patients who developed dementia during the study period.
Regular users of PPIs (2,950 patients, mostly female and average age nearly 84) had a 44% increased risk of dementia compared with those (70,729 patients, mostly female and average age 83) not receiving PPI medication, according to the results.
Limitations to the study include the authors only being able to integrate some other risk factors for dementia into the analysis from the data.
“The present study can only provide a statistical association between PPI use and risk of dementia. The possible underlying causal biological mechanism has to be explored in future studies," the study noted. "To evaluate and establish direct cause and effect relationships between PPI use and incident dementia in the elderly, randomized, prospective clinical trials are needed.”
The news should not impact the sale of nonprescription PPIs, however.
“Millions of American consumers continue to rely on safe and effective nonprescription/over-the-counter proton pump inhibitors for self-care to relieve frequent heartburn symptoms," noted the Consumer Healthcare Products Association in response to the JAMA article. "The recent article in the Journal of the American Medical Association Neurology regarding PPIs and risk for dementia did not examine OTC PPI use. Rather, the authors only looked at prescription PPI use among a group of patients 75 years of age or older in Germany between 2004 and 2011."