Proton pump inhibitors and all-cause mortality risk among cancer patients  

作　　者：Arunkumar Krishnan Carolin Victoria Schneider Declan Walsh 

机构地区：[1]Department of Supportive Oncology,Atrium Health Levine Cancer,Charlotte,NC 28204,United States [2]Department of Medicine,Section of Hematology and Oncology,Wake Forest University School of Medicine,Winston-Salem,NC 27101,United States [3]Department of Medicine Ⅲ,Gastroenterology,Metabolic Diseases,and Intensive Care,University Hospital RWTH Aachen,Aachen 52074,Germany

出　　处：《World Journal of Clinical Oncology》2025年第1期34-42,共9页世界临床肿瘤学杂志（英文）

摘　　要：BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights

关 键 词：All-cause mortality Cancer Histamine-2 receptor antagonists MORTALITY MALIGNANCY Proton pump inhibitors CARCINOMA OUTCOME 

分 类 号：R73[医药卫生—肿瘤]