APPLICATION OF PROTON PUMP INHIBITORS AGAINST THE BACKGROUND OF USE OF GCSs IN PATIENTS WITH IBDs: TRIBUTE TO TRADITION IN GASTROENTEROLOGY OR NECESSITY?


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The need for systemic glucocorticosteroids (GCSs) to induce remission in patients with inflammatory bowel diseases (IBDs) is beyond doubt. Thus, this group of patients is at risk of developing adverse events during the therapy, including from the upper gastrointestinal tract (GIT). GCSs have the ability to reduce the protective and reparative functions of the gastric and duodenal mucosa, thereby increasing the possibility of erosive-ulcerative changes in the gastroduodenal zone. Therefore, the use of proton pump inhibitors (PPIs) is certainly capable of reducing the risk of ulcerogenesis and gastrointestinal bleeding. But, like any group of drugs, PPIs are not devoid of side effects, and the risks of some of them are higher in patients with IBDs. In modern reports on the results of large studies, the potential benefit from the application of acid-suppressive therapy has been proved only for people with increased risks of adverse events, for example, concomitant use of GCSs and non-steroidal anti-inflammatory drugs, elderly age, history of erosive and ulcerative diseases of the upper gastrointestinal tract, history of gastrointestinal bleeding. Thus, a clear understanding of the potential benefits of PPI therapy for patients with IBDs who are on GCS therapy is required.

Full Text

Restricted Access

About the authors

M. I Skalinskaya

North-Western State Medical University n.a. I.I. Mechnikov

Email: mskalinskaya@yahoo.com
PhD, Associate Professor at the Department of Propaedeutics of Internal Diseases, Gastroenterology and Dietology

E. V Skazyvayeva

North-Western State Medical University n.a. I.I. Mechnikov

I. G Bakulin

North-Western State Medical University n.a. I.I. Mechnikov

I. V Lapinsky

North-Western State Medical University n.a. I.I. Mechnikov

References

  1. Ивашкин В.Т., Шелыгин Ю.А., Халиф И.Л. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России по диагностике и лечению язвенного колита. Колопроктология. 2017;1(59):6-30.
  2. Luo J.C., Chang F.Y., Lin H.Y., et al. The potential risk factors leading to peptic ulcer formation in autoimmune disease patients receiving corticosteroid treatment. Aliment. Pharmacol. Ther 2002;16(7):1241-48.
  3. Conn H.O., Blitzer B.L. Nonassociation of adrenocorticosteroid therapy and peptic ulcer. N. Engl. J. Med. 1976;294(9):473-79. doi: 10.1056/NEJM197602262940905
  4. Messer J., Reitman D., Sacks H.S. et al. Association of adrenocorticosteroid therapy and peptic-ulcer disease. N. Engl. J. Med. 1983;309(1):21-4. doi: 10.1056/nejm198307073090105
  5. Hernandez-Dfaz S., Rodriguez L.A. Steroids and risk of upper gastrointestinal complications. Am. J. Epidemiol. 2001;153(11):1089-93.
  6. Okazaki K., Chiba T., Hajiro K.J. Downregulation of gastric mucin gene expression and its biosynthesis by dexamethasone in the human. Clin. Gastroenterol. 1998;27(1):91-6.
  7. Luo J.C., Chang F.Y, et al. Gastric mucosal injury in systemic lupus erythematosus patients receving pulse methylprednisolone therapy. Br. J. Clin. Pharmacol. 2009;68(2):252-59. Doi: 10.1111/j. 1365-2125.2009.03445.x.
  8. Rice J.B, White A.G., Scarpati L.M. Long-term Systemic Corticosteroid Exposure: A Systematic Literature Review. Clin. Ther. 2017;39(11):2216 29. doi: 10.1016/j.clinthera.2017.09.011
  9. Manson S.C., Brown R.E., Cerulli A. The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Respir. Med. 2009;103(7):975-94. Doi: 10.1016/j. rmed.2009.01.003.
  10. Yang Y.X., Metz D.C. Safety of proton pump inhibitor exposure. Gastroenterology. 2010;139:1115-27.
  11. Chiu H.F., Huang Y.W., Chang C.C. Use of proton pump inhibitors increased the risk of hip fracture: a population-based case-control study. Pharmacoepidemiol. Drug Saf. 2010;19(11):1131-36. Doi: 10.1002/ pds.2026.
  12. Yu E.W., Bauer S.R., Bain P.A. Proton pump inhibitors and risk of fractures: a metaanalysis of 11 international studies. Am. J Med. 2011;124(6):519-26. Doi: 10.1016/j. amjmed.2011.01.007.
  13. Eom C.S., Jeon C.Y., Lim J.W., et al. Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis. CMAJ. 2011;183(3):310-19. Doi: 10.1503/ cmaj.092129.
  14. Dial S., Delaney J.A., Barkun A.N. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA. 2005;294(23):2989-95. Doi: 10.1001/ jama.294.23.2989.
  15. Thomson A.B., Sauve M.D., Kassam N., et al. Safety of the long-term use of proton pump inhibitors. World J. Gastroenterol. 2010;16(19):2323-30.
  16. Kanno T., Matsuki T., Oka M., et al. Gastric acid reduction leads to an alteration in lower intestinal microflora. Biochem. Biophys. Res. Commun. 2009;381:666-70.
  17. Alkim H., Unal S., Okur H., et al. Omeprazole inhibits natural killer cell functions. Dig Dis Sci. 2008;53:347-51.
  18. Yoshida N., Yoshikawa T., Tanaka Y., et al. A new mechanism for anti-inflammatory actions of proton pump inhibitors - inhibitory effects on neutrophil- endothelial cell interactions. Aliment. Pharmacol. Ther. 2000;14:74-81.
  19. Neal K.R., Scott H.M., Slack R.C., et al. Omeprazole as a risk factor for Campylobacter gastroenteritis: case-controlstudy. BMJ. 1996:312:414-15.
  20. Garcia Rodriguez L.A., Ruigomez A., Panes J. Use of acid-suppressing drugs and the risk of bacterial gastroenteritis. Clin. Gastroenterol. Hepatol. 2007;5(12):1418-23. Doi: 10.1016/j. cgh.2007.09.010.
  21. Aseeri M., Schroeder T, Kramer J. Gastric acid suppression by proton pump inhibitors as a risk factor for Clostridium difficile-associated diarrhea in hospitalized patients. Am. J. Gastroenterol. 2008;103:2308-13. doi: 10.1111/j.1572-0241.2008.01975.x
  22. Su T., Lai S., Lee A., et al. Meta-analysis: proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. J Gastroenterol. 2018;53(1):27-36. doi: 10.1007/s00535-017- 1371-9.
  23. Cohen-Mekelburg S., Tafesh Z., Coburn E., et al.Testing and Treating Small Intestinal Bacterial Overgrowth Reduces Symptoms in Patients with Inflammatory Bowel Disease. Dig. Dis. Sci. 2018. Doi: https://doi.org/10.1007/s10620-018-5109-1.
  24. Riley T.V., Kimura T. The Epidemiology of Clostridium difficile Infection in Japan: A Systematic Review, infect. Dis. Ther. 2018;7(1):39-70.
  25. Takagi T., Naito Y., inoue R. The influence of long-term use of proton pump inhibitors on the gut microbiota: an age-sex-matched case-control study. J. Clin. Biochem. Nutr. 2018;62(1):100-5. doi: 10.3164/jcbn.17-78.
  26. Roughead E.E., Chan E.W., Choi N.K., et al. Proton pump inhibitors and risk of Clostridium difficile infection: a multi-country study using sequence symmetry analysis. Expert Opin. Drug Saf. 2016;15(12):1589-95. doi: 10.1080/14740338.2016.1238071.
  27. Trifan A., Stanciu C., Girleanu I., et al. Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis. World J. Gastroenterol. 2017;23(35):6500-15. doi: 10.3748/wjg.v23.i35.6500.
  28. Zirk-Sadowski J., Masoli J.A., Delgado J., et al. Proton-Pump inhibitors and Long-Term Risk of Community-Acquired Pneumonia in Older Adults. J. Am. Geriatr. Soc. 2018. doi: 10.1111/jgs.15385.
  29. Toruner M., Loftus E.V. Jr, Harmsen W.S., et al. Risk factors for opportunistic infections in patients with inflammatory bowel disease. Gastroenterology. 2008;134:929-36. Doi: 10.1053/j. gastro.2008.01.012.
  30. Juillerat P., Schneeweiss S., Cook E.F., et al. Drugs that inhibit gastric acid secretion may alter the course of inflammatory bowel disease. Aliment Pharmacol Ther. 2012;36(3):239-47. P 239-47. doi: 10.1111/j.1365-2036.2012.05 1 73.
  31. Aberra F., Lewis J.D., Lichtenstein G.R., et al. Proton pump inhibitor use and the risk of flare of inflammatory bowel disease. Gastroenterology. 2006;130:A649.
  32. Shah R., Richardson P, Yu H., et al. Gastric Acid Suppression is Associated with an increased Risk of Adverse Outcomes in inflammatory Bowel Disease. Digestion. 2017;95(3):188-193. doi: 10.1159/000455008.
  33. Khan N., Abbas A.M., Almukhtar R.M., Khan A.Prevalence and predictors of low bone mineral density in males with ulcerative colitis. J. Clin. Endocrinol. Metab. 2013;98:2368-75.
  34. Dear K.L., Compston J.E., Hunter J.O. Treatments for Crohn's disease that minimise steroid doses are associated with a reduced risk of osteoporosis. Clin. Nutr. 2001;20:541-46.
  35. Van Staa T.P., Leufkens H.G., Abenhaim L., et al. Use of oral corticosteroids and risk of fractures. J. Bone Miner. Res. 2000;15:993-1000. Doi: 10.1359/ jbmr.2000.15.6.993
  36. Yang Y.X., Lewis J.D., Epstein S., Metz D.C. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296(24):2947-53. doi: 10.1001/jama.296.24.2947.
  37. Targownik L.E., Lix L.M., Metge C.J., et al. Use of proton pump inhibitors and risk of osteoporosis-related fractures. CMAJ. 2008;179(4):319-26. doi: 10.1503/cmaj.071330.
  38. Corsonello A., Lattanzio F., Bustacchini S., et al. Adverse Events of Proton Pump inhibitors: Potential Mechanisms. Curr. Drug Metab. 2018;19(2):142 54. doi: 10.2174/1389200219666171207125 351
  39. Fardet L., Kassar A., Cabane J. Corticosteroid-induced adverse events in adults: frequency, screening and prevention. Drug Saf. 2007;30(10):861-81. doi: 10.2174/1389200 219666171207125351.
  40. Munson J.C., Wahl P.M., Daniel G., et al. Factors associated with the initiation of proton pump inhibitors in corticosteroid users. Pharmacoepidemiol. Drug Saf. 2012;21(4):366-74. doi: 10.1002/pds.2350.
  41. Matoulková P., Pávek P., Malý J., Vlček J. Cytochrome P450 enzyme regulation by glucocorticoids and consequences in terms of drug interaction. Expert Opin. Drug Metab. Toxicol. 2014;10(3):425-35. doi: 10.1517/17425255.2014.878703.
  42. Williams D.M. Clinical Pharmacology of Corticosteroids. Respir Care. 2018;63(6):655-70. doi: 10.4187/respcare.06314.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies