Proton-pump inhibitor overuse: a cautionary tale in misguided benefit (Letter)
File version
Accepted Manuscript (AM)
Author(s)
Nath, Karthik
Reyaldeen, Reza
Palamuthusingam, Dharmenaan
Griffith University Author(s)
Year published
2019
Metadata
Show full item recordAbstract
We congratulate Leitinger et al.1 and co‐authors for their comprehensive review on the use of proton‐pump inhibitors (PPI) in patients with malignant haematological conditions. The authors highlight the high prophylactic and often extended use of PPI in patients receiving treatment for multiple myeloma, lymphoma and recipients of autologous haemopoietic stem cell transplantation. In those with multiple myeloma or lymphoma there was no strong indication for the initiation of PPI in more than half the patients studied. Furthermore, therapy was typically continued for a protracted duration, sometimes indefinitely despite no ...
View more >We congratulate Leitinger et al.1 and co‐authors for their comprehensive review on the use of proton‐pump inhibitors (PPI) in patients with malignant haematological conditions. The authors highlight the high prophylactic and often extended use of PPI in patients receiving treatment for multiple myeloma, lymphoma and recipients of autologous haemopoietic stem cell transplantation. In those with multiple myeloma or lymphoma there was no strong indication for the initiation of PPI in more than half the patients studied. Furthermore, therapy was typically continued for a protracted duration, sometimes indefinitely despite no indication for therapy. Studies involving the general population from the United States and the United Kingdom have also reported up to 70% of PPI prescription without indication.2, 3 The authors have also highlighted the paucity of robust evidence on the indications for prophylaxis in those patients receiving glucocorticoid therapy. Their national survey demonstrated high variability in clinical practice and an overall lack of institutional protocols for the use of PPI therapy in this setting.
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View more >We congratulate Leitinger et al.1 and co‐authors for their comprehensive review on the use of proton‐pump inhibitors (PPI) in patients with malignant haematological conditions. The authors highlight the high prophylactic and often extended use of PPI in patients receiving treatment for multiple myeloma, lymphoma and recipients of autologous haemopoietic stem cell transplantation. In those with multiple myeloma or lymphoma there was no strong indication for the initiation of PPI in more than half the patients studied. Furthermore, therapy was typically continued for a protracted duration, sometimes indefinitely despite no indication for therapy. Studies involving the general population from the United States and the United Kingdom have also reported up to 70% of PPI prescription without indication.2, 3 The authors have also highlighted the paucity of robust evidence on the indications for prophylaxis in those patients receiving glucocorticoid therapy. Their national survey demonstrated high variability in clinical practice and an overall lack of institutional protocols for the use of PPI therapy in this setting.
View less >
Journal Title
Internal Medicine Journal
Volume
49
Issue
10
Copyright Statement
© 2019 Royal Australasian College of Physicians. This is the peer reviewed version of the following article: Proton-pump inhibitor overuse: a cautionary tale in misguided benefit, Internal Medicine Journal, Vol. 49, Iss. 10, October 2019, Pages 1337-1337, which has been published in final form at 10.1111/imj.14452. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
Subject
Cardiovascular medicine and haematology
Clinical sciences
Life Sciences & Biomedicine
General & Internal Medicine
Science & Technology