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001-es BibID:	BIBFORM078868
035-os BibID:	(PMID)31464790
Első szerző:	Janka Tamás
Cím:	Deleterious effect of proton pump inhibitors on the disease course of cirrhosis / Tamas Janka, Tamas Tornai, Brigitta Borbely, David Tornai, Istvan Altorjay, Maria Papp, Zsuzsanna Vitalis
Dátum:	2020
Megjegyzések:	OBJECTIVES: Proton pump inhibitors (PPIs) are widely prescribed to patients with liver cirrhosis. We hypothesized that long-standing PPI use is associated with spontaneous bacterial peritonitis (SBP) and accelerated development of disease-specific complications and liver-related death. METHODS: A 5-year follow-up observational cohort study assessed the impact of long-standing PPI use on the clinical course of cirrhosis in a large referral patient cohort. 350 patients with cirrhosis (males: 188, females: 162, ages: 56?6 years, alcohol: 242 [69.1%], Child-Pugh stage A/B/C: 206/108/36) were assigned to two groups: regular PPI users (n=196) and non-users (n=154). Occurrence of SBP, decompensation events (development of ascites, hepatic encephalopathy and variceal bleeding), and liver-related death were assessed. RESULTS: Regular PPI use was associated with an increased cumulative probability of SBP compared to non-users [CP: 55% vs 24.8%, HR: 4.25 (95%CI: 1.42-12.67), p=0.05], but only in patients who had no previous SBP episode (n=84). A similar association was found between regular PPI use and decompensation events. The risk of the development of a first decompensation event (ascites, HE or VB) was higher in regular PPI users compared to non-users, in patients with compensated clinical stage at enrollment (HR: 2.81, 95%CI: 1.31-6.01, p=0.008, n=146). The risk of liver-related death was also significantly increased among regular PPI users (p<0.001). In multivariate Cox-regression analysis, regular PPI use (HR: 2.81, 95%CI: 1.43-5.51, p=0.003) and MELD score (HR: 1.21, 95%CI: 1.08-1.35, p<0.001) was an independent predictor of mortality. In the present follow-up cohort study, long-term PPI use was associated with the development of SBP and a progressive disease course in patients with cirrhosis that may have been caused by enhanced pathologic BT, accelerated development of BT-dependent disease-specific complications, and liver-related death.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban proton pump inhibitors bacterial translocation spontaneous bacterial peritonitis disease progression mortality
Megjelenés:	European Journal of Gastroenterology & Hepatology. - 32 : 2 (2020), p. 257-264. -
További szerzők:	Tornai Tamás István (1984-) (belgyógyász) Borbély Brigitta Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00048 GINOP EFOP-3.6.1-16-2016-00022 EFOP EFOP-3.6.2-16-2017-00006 EFOP BO/00232/17/5 Egyéb ÚNKP-17-4 Egyéb
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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