notificationsアラート設定
~
検索条件をクリア

アブストラクト

Title PPI長期投与で懸念される副作用
Subtitle 特集 酸分泌抑制薬の功罪 [総論]
Authors 今枝博之*, 都築義和, 宮口和也**, 芦谷啓吾, 松本悠, 塩味里恵, 山岡稔, 大庫秀樹*, 中元秀友**
Authors (kana)
Organization *埼玉医科大学消化管内科, **総合診療内科
Journal 消化器内視鏡
Volume 32
Number 8
Page 1098-1105
Year/Month 2020 / 8
Article 報告
Publisher 東京医学社
Abstract 「要旨」プロトンポンプ阻害薬(PPI)は広く普及しており, 胃食道逆流症や低用量アスピリン・非ステロイド性抗炎症薬による胃潰瘍・十二指腸潰瘍の再発予防に対して長期間投与することも多い. PPIの長期間服用によりさまざまな疾患や病態との関連性が報告されている. PPIの長期服用による副作用の多くはPPIによる直接の傷害のみならず, 胃酸分泌抑制による腸内細菌叢の変化, 吸収障害, ガストリン分泌亢進, 代謝経路の競合による他剤への影響などが関与して惹起されると考えられる. 高齢者や併存疾患を有する患者ほどPPIを投与される機会が多いが, さまざまな因子の関与があるため, データのみをうのみにして副作用を懸念するあまりPPIを中止することは, PPIが必要な患者に逆に不利益となることもある. 臨床の現場ではPPIの必要性と最小限の投与量および投与期間について, 患者ごとに検討することが望ましい.
Practice 臨床医学：内科系
Keywords プロトンポンプ阻害薬, 長期投与, 副作用, proton pump inhibitor, long-term administration, adverse effect
  • 全文ダウンロード： 従量制、基本料金制の方共に1,023円(税込) です。
download全文ダウンロード(3.36MB)

参考文献

  • 1. Vaezi MF, Yang YX, Howden CW : Complications of Pro-ton Pump Inhibitor Therapy. Gastroenterology 153 : 35-48, 2017
  • 2. Fossmark R, Martinsen TC, Waldum HL : Adverse effects of proton pump inhibitors-Evidence and plausibility. Int J Mol Sci 20 : 5203, 2019
    pubmed
  • 3. 白井聖一, 前北隆雄, 加藤 順ほか : 酸分泌抑制療法の課題と今後 (3) その他の課題-肺炎・骨関節疾患・認知症など. 臨消内科 32 : 225-234, 2017
  • 4. 神谷 武 : 酸分泌抑制薬長期投薬の安全性. 日臨 74 : 1387-1391, 2016
    Medical*Online
  • 5. Hafiz RA, Wong C, Paynter S et al : The risk of commu-nity-acquired enteric infection in proton pump inhibitor therapy: systematic review and meta-analysis. Ann Pharma-cother 52 : 613-622, 2018
残りの39件を表示する
  • 6. Oshima T, Wu L, Li M et al : Magnitude and direction of the association between Clostridium difficile infection and proton pump inhibitors in adults and pediatric patients: a systematic review and meta-analysis. J Gastroenterol 53 : 84-94, 2018
  • 7. Takagi T, Naito Y, Inoue R et al : 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 62 : 100-105, 2018
    pubmed
  • 8. Lo WK, Chan WW : Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: A meta-analysis. Clin Gastroenterol Hepatol 11 : 483-490, 2013
    pubmed
  • 9. Su T, Lai S, Lee A et al : Meta-analysis: proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. J Gastroenterol 53 : 27-36, 2018
  • 10. Giuliano C, Wilhelm SM, Kale-Pradhan PB : Are proton pump inhibitors associated with the development of com-munity-acquired pneumonia? A meta-analysis. Expert Rev Clin Pharmacol 5 : 337-344, 2012
  • 11. Ma C, Shaheen AA, Congly SE et al : Interpreting reported risks associated with use of proton pump inhibitors: residual confounding in a 10-year analysis of national ambulatory data. Gastroenterology 158 : 780-782, 2020
  • 12. Myles PR, Hubbard RB, McKeever TM et al : Risk of community-acquired pneumonia and the use of statins, ace inhibitors and gastric acid suppressants: a population-based case-control study. Pharmacoepidemiol Drug Saf 18 : 269-275, 2009
    pubmed
  • 13. Sarkar M, Hennessy S, Yang YX : Proton-pump inhibitor use and the risk for community-acquired pneumonia. Ann Intern Med 149 : 391-398, 2008
    pubmed
  • 14. Herzig SJ, Howell MD, Ngo LH et al : Acid-suppressive medication use and the risk for hospital-acquired pneumo-nia. JAMA 301 : 2120-2128, 2009
  • 15. Gomm, W, von Holt K, Thome F et al : Association of proton pump inhibitors with risk of dementia: a pharma-coepidemiological claims data analysis. JAMA Neurol 73 : 410-416, 2016
  • 16. Haenisch B, von Holt K, Wiese B et al : Risk of dementia in elderly patients with the use of proton pump inhibitors. Eur Arch Psychiatry Clin Neurosci 265 : 419-428, 2015
    pubmed
  • 17. Song YQ, Li Y, Zhang SL et al : Proton pump inhibitor use does not increase dementia and Alzheimer's disease risk: An updated meta-analysis of published studies involving 642305 patients. PLoS One 14 : e0219213, 2019
  • 18. Hussain S, Siddiqui AN, Habib A et al : Proton pump inhib-itors' use and risk of hip fracture: a systematic review and meta-analysis. Rheumatol Int 38 : 1999-2014, 2018
  • 19. Nassar Y, Richter S : Proton-pump inhibitor use and frac-ture risk: an updated systematic review and meta-analysis. J Bone Metab 25 : 141-151, 2018
  • 20. Targownik LE, Goertzen AL, Luo Y et al : Long-term proton pump inhibitor use is not associated with changes in bone strength and structure. Am J Gastroenterol 112 : 95-101, 2017
  • 21. Katz PO, Gerson LB, Vela MF : Guidelines for the diagno-sis and management of gastroesophageal reflux disease. Am J Gastroenterol 108 : 308-328, 2013
  • 22. Lam JR, Schneider JL, Zhao W et al : Proton pump inhibi-tor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 310 : 2435-2442, 2013
  • 23. Attwood SE, Ell C, Galmiche JP et al : Long-term safety of proton pump inhibitor therapy assessed under con-trolled, randomised clinical trial conditions: Data from the SOPRAN and LOTUS studies. Aliment Pharmacol Ther 41 : 1162-1174, 2015
  • 24. Lam JR, Schneider JL, Quesenberry CP et al : Proton pump Inhibitor and histamine-2 receptor antagonist use and iron deficiency. Gastroenterology 152 : 821-829, 2017
    pubmed
  • 25. Liao S, Gan L, Mei Z : Does the use of proton pump inhib-itors increase the risk of hypomagnesemia: An updated systematic review and meta-analysis. Medicine 98 : e15011, 2019
  • 26. Lazarus B, Chen Y, Wilson FP et al : Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 176 : 238-246, 2016
    pubmed
  • 27. Hart E, Dunn TE, Feuerstein S et al : Proton pump inhib-itors and risk of acute and chronic kidney disease: a retrospective cohort study. Pharmacotherapy 39 : 443-453, 2019
  • 28. Ma YJ, Cao ZX, Li Y et al : Proton pump inhibitor use increases hepatic encephalopathy risk: A systematic review and meta-analysis. World J Gastroenterol 25 : 2675-2682, 2019
  • 29. Xu HB, Wang HD, Li CH et al : Proton pump inhibitor use and risk of spontaneous bacterial peritonitis in cirrhotic patients: a systematic review and meta-analysis. Genet Mol Res 14 : 7490-7501, 2015
    pubmed
  • 30. Naito Y, Kashiwagi K, Takagi T et al : Intestinal dysbiosis secondary to proton-pump inhibitor use. Digestion 97 : 195-204, 2018
    pubmed
  • 31. Cheung KS, Chan EW, Wong AYS et al : Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study. Gut 67 : 28-35, 2017
    pubmed
  • 32. Kuipers EJ, Lundell L, Klinkenberg-Knol EC et al : Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication. N Engl J Med 334 : 1018-1022, 1996
    pubmed
  • 33. Yang YX, Hennessy S, Propert K et al : Chronic proton pump inhibitor therapy and the risk of colorectal cancer. Gastroenterology 133 : 748-754, 2007
    pubmed
  • 34. Graham C, Orr C, Bricks CS et al : A retrospective analysis of the role of proton pump inhibitors in colorectal cancer disease survival. Curr Oncol 23 : e583-588, 2016
    pubmed
  • 35. Kwok CS, Jeevanantham V, Dawn B et al : No consist-ent evidence of differential cardiovascular risk amongst proton-pump inhibitors when used with clopidogrel: meta-analysis. Int J Cardiol 167 : 965-974, 2013
  • 36. Malhotra K, Katsanos AH, Bilal M et al : Cerebrovascular outcomes with proton pump inhibitors and thienopyridines: a systematic review and meta-analysis. Stroke 49 : 312-318, 2018
    pubmed
  • 37. Watanabe T, Fujiwara Y, Chan FKL : Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review. J Gastroenterol 55 : 481-495, 2020
  • 38. Beaugerie L, Pardi DS : Review article: drug-induced microscopic colitis-proposal for a scoring system and review of the literature. Aliment Pharmacol Ther 22 : 277-284, 2005
    pubmed
  • 39. 鎌田智有, 畑野 悠, 高張康介ほか : プロトンポンプ阻害薬内服による胃粘膜病変-胃ポリープの増大・黒点・多発性白色扁平隆起-. 消化器内視鏡 31 : 890-898, 2019
    Medical*Online
  • 40. Martin FC, Chenevix-Trench G, Yeomans ND :Systematic review with meta-analysis: fundic gland polyps and proton pump inhibitors. Aliment Pharmacol Ther 44 : 915-925, 2016
    pubmed
  • 41. Duncan SJ, Howden CW : Proton pump inhibitors and risk of rhabdomyolysis. Drug Saf 40 : 61-64, 2017
    pubmed
  • 42. Sandholdt LH, Bygum A : Proton Pump Inhibitor-Induced Subacute Cutaneous Lupus Erythematosus. Br J Dermatol 170 : 342-351, 2014
    pubmed
  • 43. Almario CV, Chey WD, Spiegel BMR : Increased risk of COVID-19 among users of proton pump inhibitors. Am J Gastroenterol, 2020. https://journals.lww.com/ajg/Documents/AJG-20-1811_R1(PUBLISH%20AS%20WEBPART).pdf
  • 44. Xiao F, Tang M, Zheng X et al : Evidence for gastrointes-tinal infection of SARS-CoV-2. Gastroenterology 158 : 1831-1833. e3, 2020
はじめての方へ
個人／法人会員登録のご案内