Studies document risks from common acid-suppressing meds

Something your patients should know …

Studies document risks from common acid-suppressing meds

Proton pump inhibitors -- commonly prescribed medications that suppress acid in the stomach -- appear to be associated with fractures in postmenopausal women and bacterial infections in many patients, and higher doses do not appear any more beneficial for treating bleeding ulcers, according to a series of reports in the May 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"A staggering 113.4 million prescriptions for proton pump inhibitors are filled each year, making this class of drugs, at $13.9 billion in sales, the third highest seller in the United States," wrote Mitchell H. Katz, MD, of the San Francisco Department of Public Health, in an editorial accompanying the reports. These medications are used to treat inflammation of the esophagus, gastroesophageal reflux disease (GERD), ulcers and several other conditions, but evidence suggests that 53-69% of proton pump inhibitor prescriptions are for inappropriate indications, he noted.

The studies found that use of proton pump inhibitors appears associated with fractures in postmenopausal women. Over more than eight years of follow-up with 161,806 women ages 50 to 79, there was an increased risk of spine and forearm or wrist fractures, in addition to total fractures. Also, daily proton pump inhibitor use is associated with an estimated 74% increase in infection with Clostridium difficile and a 42% increased risk of recurrence.

"Harm will result if these commonly used medications are prescribed for conditions for which there is no benefit, such as non-ulcer dyspepsia," the researchers concluded.

The articles are part of the journal's series, "Less Is More," highlighting areas where measures of health are worse when patients receive more health services.

"Evidence suggests that providing excessive health care service is most likely to occur in situations in which there is not strong evidence to document the benefit and harms of the service," the authors warned.

"This is the type of information chiropractors need to make available to their patients," stated Terry A. Rondberg, DC, founder and CEO of the World Chiropractic Alliance and publisher of The Chiropractic Journal. "It's a good idea to print up 'For Your Information' sheets and leave them in your waiting room."

Articles with information like this can be found weekly at the WCA's Health Watch and Wellness for Mind and Body.