Nasser Alkhushaym1,2, Abdulaali R Almutairi1,3, Abdulhamid Althagafi1,4, Saad B Fallatah1,5, Mok Oh1, Jennifer R Martin6,7, Hani M Babiker8,7, Ali McBride7,7,9, Ivo Abraham1,7,7,10. 1. Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, The University of Arizona, Tucson, AZ, USA. 2. Department of Clinical Pharmacy, Royal Commission Health Services Program, Jubail, Saudi Arabia. 3. SFD-Drug sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia. 4. Clinical Pharmacy Department, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. 5. Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Medina, Saudi Arabia. 6. Arizona Health Sciences Library, The University of Arizona, Tucson, AZ, USA. 7. Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA. 8. Department of Hematology & Oncology, College of Medicine, The University of Arizona, Tucson, AZ, USA. 9. University of Arizona Cancer Center, Tucson, AZ, USA. 10. Department of Family and Community Medicine, College of Medicine, The University of Arizona, Tucson, AZ, USA.
Abstract
Objectives: To estimate the pancreatic cancer risk among subjects exposed versus not exposed to proton pump inhibitors. Methods: The authors searched PubMed, EMBASE, Scopus, Cochrane Library, and clinicaltrials.gov to identify relevant studies. The authors quantified pancreatic cancer risk among subjects exposed versus not exposed to PPIs, expressed as the pooled (adjusted) odds ratio (OR/aOR) and 95% confidence interval (95%CI) in overall and sensitivity analyses. Results: One randomized trial, two cohort, four case-control, and five nested case-control studies with 700,178 subjects (73,985 cases; 626,193 controls) were retained. PPI exposure was associated with pancreatic cancer risk (OR = 1.75, 95%CI = 1.12-2.72, I2 = 99%); confirmed in sensitivity analyses for high-quality studies, observational studies, case-control studies, studies with pancreatic cancer as the primary outcome, and in sensitivity analyses for diabetes and obesity but not for pancreatitis and smoking. This association was independent of the duration and Defined Daily Dose of PPI exposure. Rabeprazole had a singular significant association with pancreatic cancer (OR = 5.40, 95%CI = 1.98-14.703, I2 = 87.9%). Conclusion: The class of PPIs is associated with a 1.75-fold increase in pancreatic cancer risk, confirmed in sensitivity analyses.
Objectives: To estimate the pancreatic cancer risk among subjects exposed versus not exposed to proton pump inhibitors. Methods: The authors searched PubMed, EMBASE, Scopus, Cochrane Library, and clinicaltrials.gov to identify relevant studies. The authors quantified pancreatic cancer risk among subjects exposed versus not exposed to PPIs, expressed as the pooled (adjusted) odds ratio (OR/aOR) and 95% confidence interval (95%CI) in overall and sensitivity analyses. Results: One randomized trial, two cohort, four case-control, and five nested case-control studies with 700,178 subjects (73,985 cases; 626,193 controls) were retained. PPI exposure was associated with pancreatic cancer risk (OR = 1.75, 95%CI = 1.12-2.72, I2 = 99%); confirmed in sensitivity analyses for high-quality studies, observational studies, case-control studies, studies with pancreatic cancer as the primary outcome, and in sensitivity analyses for diabetes and obesity but not for pancreatitis and smoking. This association was independent of the duration and Defined Daily Dose of PPI exposure. Rabeprazole had a singular significant association with pancreatic cancer (OR = 5.40, 95%CI = 1.98-14.703, I2 = 87.9%). Conclusion: The class of PPIs is associated with a 1.75-fold increase in pancreatic cancer risk, confirmed in sensitivity analyses.
Authors: Soungmun Kim; Seogsong Jeong; Sun Jae Park; Jooyoung Chang; Seulggie Choi; Yoosun Cho; Joseph C Ahn; Gyeongsil Lee; Joung Sik Son; Sang Min Park Journal: J Clin Med Date: 2022-05-19 Impact factor: 4.964