in the gut to go along with that heartburn medicine? A new study in Gut, published in late October, suggests that some of the top-selling drugs in the world may double the risk of stomach cancer. The risk was linked to long-term use of proton pump inhibitors, a class of drugs that includes Prilosec and Nexium, typically used for heartburn and related digestivetrack discomfort.
Note that the overall chances of developing cancer are very small—less than 1 percent of the people studied were diagnosed with this kind of cancer over seven years, and stomach cancer accounts for only 1.7 percent of all cancers diagnosed in the U.S. every year. And the pool of people at risk shrinks even smaller when you consider that the study looked only at people who had been treated for an infection linked with ulcers. The bacterium responsible for this infection, Helicobacter
pylori, is also associated with an increased risk of stomach cancer.
That said, however, the increased relative risk is alarmingly high. People who used the medications for more than three years may have increased their risk of developing stomach cancer eightfold. “Ultimately, the risk of gastric cancer is quite low, but overall, the field is moving toward being cautious with these agents,” Dr. Yelena Janjigian, a gastric cancer specialist at Memorial Sloan Kettering Cancer Center, tells
Newsweek. “Even before this paper came out, the general trend has been to take people off the therapy.”
She notes that the type of stomach tumors in this study isn’t seen as commonly in Western countries as they are in Asia, where this study was done.
For a control group in this study, researchers used medications that treat heartburn in a different way, including Zantac and Pepcid AC, to ensure it was really the proton pump inhibitors behind the effect observed and not something else.
Medications such as Zantac and proton pump inhibitors work by decreasing the acid that the stomach lining makes. Zantac blocks a chemical called histamine that can activate certain pumps that need to be triggered for the stomach to produce acid. Medications like Prilosec and Nexium block those pumps directly.
“Even before this paper came out, the general trend has been to take people off this therapy.”
Nexium is one of the best-selling drugs for Astrazeneca. In 2016, it brought in over $2 billion in revenue, according to the company’s recent annual report. “We are confident in the safety and efficacy of Nexium and Prilosec when used in accordance with the Fda-approved label, which has been established through numerous clinical trials,” says Astrazeneca spokeswoman Michele Meixell.
PURPLE PROS Proton pump inhibitors like Nexium and Prilosec bring relief by blocking the pumps that produce acid in the stomach.