| Roman Bystrianyk 2005-06-02, 10:46 pm |
| http://www.healthsentinel.com/org_n...ist_item&id=040
Roman Bystrianyk, "Proton Pump Inhibitors Don't Improve Life
Expectancy but Do Decrease Need for Surgery", Health Sentinel, June 3,
2005,
Proton Pump Inhibitors, or PPIs, are medications that decrease the
amount of stomach acid. The gastric acid pump produces stomach acid and
PPIs bind to this pump and block stomach acid. Drugs in this class are
Esomeprazole (Nexium), Omeprazole (Prilosec), Lansoprazole (Prevacid),
Pantoprazole (Protonix), and Rabeprazole (Aciphex).
Proton pump inhibitors are used to heal stomach and duodenal ulcers.
This includes stomach ulcers caused by taking nonsteroidal
anti-inflammatory drugs or NSAIDs. In the United States NSAIDs account
for over 100,000 people being hospitalized each year due to internal
bleeding which results in at least 16,500 deaths.
In the March Issue of the British Medical Journal the authors of a
study examined 21 randomized controlled trials comprising 2,915
patients on PPIs to determine their impact on mortality, rebleeding,
and the need for surgery.
"Proton pump inhibitors are widely used for patients with ulcer
bleeding of varying severity, though they have not been specifically
approved for that indication. Given the morbidity, mortality, and
healthcare costs associated with bleeding peptic ulcer, it is important
to establish definitively whether early treatment with proton pump
inhibitors is associated with any meaningful clinical benefit."
In their analysis the authors found that 71 of the 1371 or 5.2% of the
patients using PPI treatment died, whereas, in the control group 65 of
the 1403 patients or 4.6% died. Despite this increase in death the
authors state that they consider this result unlikely based on,
"clinical grounds". The authors did find that the rate of
rebleeding in the PPI group was 10.6%, but much higher in the control
group at 18.7%. This resulted in less surgical intervention necessary
in the PPI group (8.4%), whereas, the control group required surgical
intervention more often (13.0%).
The authors conclude that, "In summary, proton pump inhibitor
treatment has not been shown to reduce mortality after ulcer bleeding.
It is, however, a remarkably consistent observation that such treatment
reduces rates of rebleeding and, in general, the need for surgical
intervention. This may be associated with important cost savings, which
should be further evaluated in formal cost effectiveness studies."
SOURCE: British Medical Journal - March 12, 2005
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