THREAD: 5 Things You Need to Know About PPIs
For many years, we've dissected the research on Proton Pump Inhibitors (PPIs) 🤔
This thread captures our publications on PPIs that can help you in clinical practice: ti.ubc.ca/?s=ppis
#MedEd #medsafety #DrugEvidence #GERD
2/6 PPI COSTS VARY CONSIDERABLY 💰
Even without differences in efficacy or safety between PPIs, costs can vary x 10. The cheapest in BC? Pantoprazole Mg 40mg or Rabeprazole 10mg. Most expensive: Dexlanzoprazole
More here: ti.ubc.ca/letter99
#MedEd #DrugCosts #GERD
3/6 RESPONSE IS VARIABLE
1 in 2 pts w/ acid reflux get symptom relief with a PPI (NNT~2) w/in 4-8 wks
Responders notice symptom relief w/in 1-9 days. If no relief in ~2 wks consider 🛑 PPI. Non-acid reflux doesn’t benefit from PPI
More here: ti.ubc.ca/letter99
#MedEd
4/6 CONSIDER DEPRESCRIBING PPIs
Cdn Association of Gastroenterology (CAG), Choosing Wisely & Cdn Deprescribing Network: PPI therapy for GI symptoms "should not be maintained long term without an attempt to stop/reduce" at least once/year in most pts
ti.ubc.ca/letter111
5/6 PPI BENEFITS and HARMS
In 2019, we noted that “In many clinical settings, we do not know whether the benefits of long-term PPI use outweigh the harms,” and that “patients on long-term PPI therapy should be reassessed.”
ti.ubc.ca/letter118
#MedEd #ptsafety #GERD
6/6 LONG TERM PPI USE CAN ↗️ RISK OF DEATH
We identified 100+ systematic reviews published in last 5 yrs of "specific harms associated with long-term PPI use" + "observational studies have identified signals of serious harms from long-term PPI" use
ti.ubc.ca/letter126
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