NEGATIVE EFFECTS OF LONG-TERM USE OF PROTON PUMP INHIBITORS (literature review)

Abstract

Introduction. Proton pump inhibitors (PPIs) are a universal group of drugs for the treatment of diseases of the gastrointestinal tract. They act by inhibiting H+-K+-ATPase in the apical membrane of the parietal cells of the gastric mucosa. Due to this pharmacological effect, it is possible to inhibit the formation of hydrochloric acid and, consequently, its secretion. PPIs have been increasingly used in recent decades, and there are concerns about overuse and many side effects, so drugs in this group should be used with caution.
According to the results of clinical studies, meta-analyses, randomized cohort studies, long-term use of PPIs has shown that patients tend to have serious side effects, such as stomach cancer, fractures or osteoporosis, kidney disease, cardiovascular disease and dementia, etc.
Purpose of the study. Рrovide data on possible complications and side effects during long-term therapy of PPIs.
Material and methods. A review was conducted to identify international experience in studying side effects, complications that develop in various organs and systems during long-term administration of PPI therapy to patients. The literature was searched in the following bibliographic and other medical databases: PubMed, Google scholarity. The search strategy included the following keywords: PPIs, proton pump inhibitors, gastroprotectors, risks, complications, etc. The methodological analysis included all types of studies. The search was limited to scientific publications in English published between January 2010 and September 2022. The criteria for inclusion in the study are: full texts contained in the database; texts in English or Russian; studies carried out or published in the last 2010-2022.
Result. As a result of the study, it was revealed that long-term use of PPIs causes a number of side effects in the body.
Discussion. PPIs therapy has radically changed the treatment of diseases associated with the harmful effects of gastric acid. They improved the outcomes of peptic ulcer disease, gastroesophageal reflux, hypersecretory disorders and gastropathies caused by the use of nonsteroidal anti-inflammatory drugs.
When deciding whether to start or continue PPI therapy, several important points should be taken into account. The frequency of side effects was mainly observed in patients receiving high daily doses of PPIs. With the exception of infections, all side effects associated with PPIs occur as part of long-term treatment, so it is necessary to shorten the duration of treatment by periodically reassessing the patient's need for antisecretory therapy in order to reduce their number.
Thus, based on the previously conducted literature and research data, we confirm the development of side effects characteristic of PPIs at the present time.
Conclusions. PPIs therapy "+" is the most effective antisecretory drugs for the treatment of acid-dependent diseases. When prescribing PPIs, the doctor should assess and control the risk of side effects and complications in the patient. The use of multiple medications increases the likelihood of their exposure.