An Emulated Clinical Trial of Deprescribing Proton Pump Inhibitors in Patients With Cirrhosis.
Am J Gastroenterol
; 119(1): 203-205, 2024 Jan 01.
Article
en En
| MEDLINE
| ID: mdl-37561055
ABSTRACT
INTRODUCTION:
Proton pump inhibitors (PPI) are overused and carry harms in cirrhosis. Deprescribing is advocated but has not been trialed. METHODS ANDFINDINGS:
We emulated a clinical trial using Medicare data. All patients were receiving chronic PPI therapy before a compensated cirrhosis diagnosis. We compared the risk death/decompensation over 3 years between continuous users and deprescribers. We find that PPI deprescription is associated with less ascites and that cumulative PPI use is associated with more ascites and encephalopathy. Ultimately, 71% of deprescribers restart PPIs.DISCUSSION:
PPI deprescribing has benefits but requires ongoing support and alternative therapies for gastrointestinal symptoms.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Deprescripciones
Límite:
Aged
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Gastroenterol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos