Exposure to proton pump inhibitors and risk of pancreatic cancer: a meta-analysis |
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| Authors: | Nasser Alkhushaym Abdulaali R. Almutairi Abdulhamid Althagafi Saad B. Fallatah Mok Oh Jennifer R. Martin |
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| Affiliation: | 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 |
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| Abstract: | ABSTRACTObjectives: 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. |
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| Keywords: | Risk pancreatic cancer proton pump inhibitors meta-analysis |
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