Heartburn drugs raise risk of early death

Over-the-counter PPI medications used by millions of people could shorten life, study finds

HEARTBURN drugs taken by millions could raise the risk of dying early, a large study suggests.

The drugs, known as proton pump inhibitors, or PPIS, have previously been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. The NHS issues more than 50 million prescriptions each year for the medication which is used to treat heartburn, ulcers and other gastrointestinal problems, but researchers say it may be time to restrict the use of the tablets.

The drugs are also available over the counter, with brand names such as Prilosec, Prevacid and Zegerid.

Researchers examined medical records of more than 275,000 PPI users and nearly 75,000 people who took another class of drugs – known as H2 blockers – to reduce stomach acid.

“No matter how we sliced and diced the data from this large data set, we saw the same thing: there’s an increased risk of death among PPI users,” said study senior author Dr Ziyad Alaly, an assistant professor of medicine at Washington University School of Medicine in the United States.

“People have the idea that PPIS are very safe because they are readily available, but there are real risks to taking these drugs, particularly for long periods of time.

“If I needed a PPI, I absolutely would take it. But I wouldn’t take it willy-nilly if I didn’t need it. And I would want my doctor to be monitoring me carefully and take me off it the moment it was no longer needed.”

Both PPIS and H2 blockers are prescribed for serious medical conditions such as upper gastrointestinal tract bleeding, gastroesophageal reflux disease and oesophageal cancer.

Over-the-counter PPIS are most often used for heartburn and indigestion.

The researchers found a 25 per cent increased risk of death in the PPI group compared with the H2 blocker group.

They calculated that, for every 500 people taking PPIS for a year, there is one extra death that would not have otherwise occurred. Given the millions of people who take PPIS regularly, Dr Al-aly said this could translate into thousands of excess deaths every year.

Dr Al-aly said that although the recommended treatment regimen for most PPIS is short – for example, two to eight weeks for ulcers – many people end up taking the drugs for months or years.

“A lot of times people get prescribed PPIS for a good medical reason, but then doctors don’t stop it and patients just keep getting refill after refill,” he said. “There needs to be periodic re-assessments … Most of the time people aren’t going to need to be on PPIS for a year or two or three.”

Dr Al-aly said over-the-counter PPIS contained the same chemical compounds as in prescription PPIS, just at lower doses, and there is no way to know how long people stay on them.

Previous studies have found that the drugs raise the risk of hip fractures by 35 per cent and a heart attack by 20 per cent. Last year German scientists found the drugs increase the risk of dementia by 44 per cent.

The Proprietary Association of Great Britain, which represents firms making over-the-counter drugs, said: “All overthe-counter medicines have been approved by the Medicines and Healthcare Products Regulatory Agency and are rigorously assessed for safety and efficacy.

“Once on the market, their safety is continually monitored in light of any emerging evidence. Those who may be concerned should speak to their GP or pharmacist before taking any medicine.” The study was published in the journal BMJ Open.