Proton pump inhibitors and risk of liver cancer and mortality in patients with chronic liver disease: a systematic review and meta-analysis.

Background: Epidemiological studies investigating the use of proton pump inhibitors (PPI) on the risk of liver cancer and/or mortality among persons with chronic liver disease (CLD) have reported conflicting results. We conducted a systematic review and meta-analysis to determine the impact of PPI u...

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Published in:European Journal of Clinical Pharmacology Vol. 76; no. 6; pp. 851 - 867
Main Authors: Song, Hyun Jin, Jiang, Xinyi, Henry, Linda, Nguyen, Mindie H., Park, Haesuk
Format: meta analysis research systematic review tables/charts Journal Article
Published: Springer Nature Jun2020
Online Access:View this record in EBSCOhost
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      dt: Jun2020
      vid: 76
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-020-02854-8
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        atl: Proton pump inhibitors and risk of liver cancer and mortality in patients with chronic liver disease: a systematic review and meta-analysis.
      aug:
        au:
          Song, Hyun Jin
          Jiang, Xinyi
          Henry, Linda
          Nguyen, Mindie H.
          Park, Haesuk
        affil: Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1225 Center Drive, 32610, Gainesville, FL, USA
      sug:
        subj:
          Liver Diseases Drug Therapy
          Chronic Disease Drug Therapy
          Proton Pump Inhibitors Adverse Effects
          Liver Neoplasms Risk Factors
          Liver Diseases Mortality
          Risk Assessment
          Human
          Systematic Review
          Meta Analysis
          Medline
          Embase
          Cochrane Library
          Confidence Intervals
          Relative Risk
          Descriptive Statistics
          Carcinoma, Hepatocellular Risk Factors
      ab: Background: Epidemiological studies investigating the use of proton pump inhibitors (PPI) on the risk of liver cancer and/or mortality among persons with chronic liver disease (CLD) have reported conflicting results. We conducted a systematic review and meta-analysis to determine the impact of PPI use on liver cancer and/or death among patients with CLD. Methods: The core databases including MEDLINE, EMBASE, and Cochrane library were searched through January 2020. We included studies, evaluating the association between PPIs and liver cancer or mortality among patients with CLD including randomized controlled, nonrandomized controlled, and observational studies. We used inverse-variance random-effects models to estimate the pooled relative risk (RR) and 95% confidence interval (CI) for liver cancer or mortality. Results: Eleven studies including 173,894 patients were selected. In three studies, individuals with CLD who used PPIs had a 67% greater risk of developing hepatocellular carcinoma (HCC) compared to nonusers (RR, 1.67; 95% CI, 1.12–2.50; I2 = 92%). Combining data from the eight studies relating PPI to overall mortality, we observed a 57% increased risk of mortality in PPI users with CLD compared to CLD nonusers (RR: 1.57; 95% CI, 1.24–1.99; I2 = 69%). Conclusion: PPI use was associated with an increased risk of HCC and mortality in patients with CLD suggesting that PPI prescriptions in patients with CLD should be considered carefully.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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