Use of Proton Pump Inhibitors Among Patients With Alcohol-Related Cirrhosis-A Danish Nationwide Cohort Study

Use of proton pump inhibitors (PPIs) may have adverse effects in patients with alcohol-related cirrhosis (ALD cirrhosis), but PPIs continue to be used by many patients.

We aimed to describe the prevalence and incidence of PPI use from filled prescriptions among patients with ALD cirrhosis and to identify predictors of PPI initiation after ALD cirrhosis diagnosis.

We used Danish nationwide healthcare registries to investigate PPI use among patients diagnosed with ALD cirrhosis from 1997 to 2022. We used multivariable Cox regression to identify predictors of PPI initiation.

We identified 41 263 patients diagnosed with ALD cirrhosis in 1997-2022. In this cohort, the prevalence of PPI use rose to 40% in 2016 and plateaued at this level through 2022. Considering time since diagnosis, 26% were using PPI at the diagnosis of ALD cirrhosis, and the prevalence peaked at 38% 3 months later. Among PPI users, 79% used more than 30 defined daily doses per year on average during the follow-up. Patients older than 50 years were more likely than younger patients to initiate PPI treatment.

The use of PPIs continues to be prevalent among patients with ALD cirrhosis, with 40% of all patients using PPIs in 2022. Within the first 3 months after diagnosis, 38% of all patients were using PPIs. Our results provide essential background information for future RCTs on the risks and benefits of prescribing or deprescribing PPIs.