Proton pump inhibitor use increases hepatic encephalopathy risk: A systematic review and meta-analysis.

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  • Author(s): Ma YJ;Ma YJ; Cao ZX; Cao ZX; Li Y; Li Y; Feng SY; Feng SY
  • Source:
    World journal of gastroenterology [World J Gastroenterol] 2019 Jun 07; Vol. 25 (21), pp. 2675-2682.
  • Publication Type:
    Journal Article; Meta-Analysis; Systematic Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE
    • Publication Information:
      Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
      Original Publication: Beijing : WJG Press, c1998-
    • Subject Terms:
      Hepatic Encephalopathy/*epidemiology ; Liver Cirrhosis/*complications ; Proton Pump Inhibitors/*adverse effects; Hepatic Encephalopathy/etiology ; Humans ; Incidence ; Risk Assessment ; Risk Factors
    • Abstract:
      Background: Several studies have been conducted to explore the association between the use of proton pump inhibitors (PPIs) and hepatic encephalopathy (HE) risk in patients with liver cirrhosis. However, their results are controversial.
      Aim: To perform a systematic review and meta-analysis to evaluate the HE risk among PPI users.
      Methods: A systematic search on PubMed, Web of Science, EMBase, and ScienceDirect databases was conducted up to December 31, 2018 for eligible studies involving PPI use and HE risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the fixed or random effects model. Publication bias was evaluated using Begg's test, Egger's test, and trim-and-fill method.
      Results: Seven studies with 4574 patients were included in the present meta-analysis. The meta-analysis results indicated a significant association between the PPI use and HE risk (OR = 1.50; 95%CI: 1.25-1.75) with low heterogeneity ( I 2 = 14.2%, P = 0.321). Although publication bias existed when Egger's tests were used ( P = 0.005), the trim-and-fill method verified the stability of the pooled result. Sensitivity analyses suggested that the results of this meta-analysis were robust.
      Conclusion: The current evidence indicates that PPI use increases HE risk in patients with liver cirrhosis. Further studies with a large data set and well-designed models are needed to validate our findings.
      Competing Interests: Conflict-of-interest statement: The authors deny any conflict of interest.
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    • Contributed Indexing:
      Keywords: Hepatic encephalopathy; Meta-analysis; Proton pump inhibitors
    • Accession Number:
      0 (Proton Pump Inhibitors)
    • Publication Date:
      Date Created: 20190619 Date Completed: 20191216 Latest Revision: 20200225
    • Publication Date:
      20240628
    • Accession Number:
      PMC6558435
    • Accession Number:
      10.3748/wjg.v25.i21.2675
    • Accession Number:
      31210718