Thread by @Drug_Evidence

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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