The proton pump inhibitors (PPI) are among the most prescribed drugs in the world. Also, the National Medicines Safety Agency (ANSM) has launched a study aimed at quantifying the use of these so-called “antacid” drugs in France. The results show that nearly 16 million people, or almost a quarter of the French population, benefited from at least one reimbursement by the Health Insurance for the issuance of PPIs on medical prescription in France in 2015.
PPIs are indicated, in particular, in the treatment of gastroesophageal reflux (GERD) and GERD esophagitis, in the prevention in patients at risk and in the treatment of gastroduodenal damage due to nonsteroidal anti-inflammatory drugs (NSAIDs), and in the eradication of Helicobacter pylori and the treatment of peptic ulcers.
The ANSM study shows that once in two, PPIs are prescribed to prevent possible heartburn when prescribingnonsteroidal anti-inflammatory drugs (NSAIDs). “However, in 80% of cases, no risk factor justifying the systematic use of a PPI in combination with an NSAID was identified” underlines the ANSM.
When are PPIs justified?
The ANSM thus wishes to recall that to date, the benefit of preventing gastroduodenal lesions in the event of taking NSAIDs, in adults, has only been established in the presence of the following risk factors:
- Be over 65 years old
- Have a history of gastric or duodenal ulcer
- Be treated with antiplatelet, anticoagulant or corticosteroid.
“It is important not to trivialize the use of PPIs. Indeed, although they are generally well tolerated in the short term, their long-term use is not without risk”. Several studies have indeed shown that antacids make the bed stomach cancer and increased the risk of kidney stones.
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