Dataset Information

Long-term use of proton-pump inhibitor on Alzheimer's disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model.

ABSTRACT:

Background

Dementia has a crucial impact on the quality of life of elderly patients and their caregivers. Proton-pump inhibitors (PPIs) are the most frequently prescribed treatment, but they have been shown to be associated with dementia. The data are inconsistent, however.

Objective

To investigate the association between PPIs use and Alzheimer's disease (AD) or all-cause dementia in six observational Korean databases using a Common Data Model (CDM) and to perform a distributed network analysis.

Methods

Subjects aged over 18 years between 1 January 2004 and 31 December 2020. Among 7,293,565 subjects from 6 cohorts, 41,670 patients met the eligibility criteria. A total of 2206 patients who were included in both cohorts or with a history of dementia were excluded. After propensity matching, 5699 propensity-matched pairs between the PPIs and histamine-2 receptor antagonist (H₂RA) users were included in this study. The primary outcome was the incidence of AD at least 365 days after drug exposure. The secondary outcome was the incidence of all-cause dementia at least 365 days after drug exposure.

Results

In the 1:1 propensity score matching, the risk of AD or all-cause dementia was not significantly different between the PPIs and H₂RA groups in all six databases. In the distributed network analysis, the long-term PPI users (⩾365 days) were unassociated with AD [hazard ratio (HR) = 0.92, 95% confidence interval (CI) = 0.68-1.23; I ² = 0%] and all-cause dementia (HR =1.04, 95% CI = 0.82-1.31; I ² = 0%) compared with H₂RA users.

Conclusion

In the distributed network analysis of six Korean hospital databases using Observational Medical Outcomes Partnership (OMOP)-CDM data, the long-term use of PPI was not associated with a statistically significantly increased risk of AD or all-cause dementia. Therefore, we suggest that physicians should not avoid these medications because of concern about dementia risk.

SUBMITTER: Kim Y

PROVIDER: S-EPMC9647297 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Long-term use of proton-pump inhibitor on Alzheimer's disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model.

Kim Yerim Y Seo Seung In SI Lee Kyung Joo KJ Kim Jinseob J Yoo Jong Jin JJ Seo Won-Woo WW Lee Hyung Seok HS Shin Woon Geon WG

Therapeutic advances in neurological disorders 20221108

<h4>Background</h4>Dementia has a crucial impact on the quality of life of elderly patients and their caregivers. Proton-pump inhibitors (PPIs) are the most frequently prescribed treatment, but they have been shown to be associated with dementia. The data are inconsistent, however.<h4>Objective</h4>To investigate the association between PPIs use and Alzheimer's disease (AD) or all-cause dementia in six observational Korean databases using a Common Data Model (CDM) and to perform a distributed ne ...[more]

PMID: 36389281

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Project description:BackgroundPrevious meta-analyses have suggested that there might be an association between the use of proton pump inhibitors (PPIs) and the development of hypomagnesemia, although the conclusions were no definitive.MethodsTo provide an update on this topic, we performed a meta-analysis of all observational studies that examined the association between the use of PPIs and the development of hypomagnesemia. A literature search was conducted in MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (January 1970 to June 2018) to identify observational studies that examined the association between the use of PPIs and the incidence and prevalence of hypomagnesemia.Study eligibility criteriaIn the absence of randomized controlled trials, we focused primarily on observational studies, including cross-sectional, case-control, retrospective, and prospective cohort studies. There was no limitation on sample size or study duration. Random-effect models meta-analyses were used to compute pooled unadjusted and adjusted odds ratios (ORs) for binary variables.ResultsSixteen observational studies were identified, including 13 cross-sectional studies, 2 case-control studies, and 1 cohort study, with a total of 131,507 patients. The pooled percentage of PPI users was 43.6% (95% confidence interval [CI] 25.0%, 64.0%). Among PPI users, 19.4% (95% CI 13.8%, 26.5%) had hypomagnesemia compared to 13.5% (95% CI 7.9%, 22.2%) among nonusers. By meta-analysis, PPI use was significantly associated with hypomagnesemia, with a pooled unadjusted OR of 1.83 (95% CI 1.26, 2.67; P = .002) and a pooled adjusted OR of 1.71 (95% CI 1.33, 2.19; P < .001). In subgroup analyses, high-dose PPI use was associated with higher odds for hypomagnesemia relative to low-dose PPI use (pooled adjusted OR 2.13; 95% CI 1.26, 3.59; P = .005).ConclusionOur findings are in support of the results of the previous meta-analyses. Furthermore, we found a dose-response between the PPI use and development of hypomagnesemia.

Dataset Information

Long-term use of proton-pump inhibitor on Alzheimer's disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model.

Background

Objective

Methods

Results

Conclusion

Publications

Long-term use of proton-pump inhibitor on Alzheimer's disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model.

Similar Datasets

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