质子抑制剂和癌症患者全因死亡风险
Arunkumar Krishnan1,2, Carolin Victoria Schneider3, Declan Walsh1
1Department of Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC 28204, United States.
World journal of clinical oncology
|January 27, 2025
概括
在癌症患者中使用质子抑制剂 (PPI) 与非使用者或基因组2受体抗剂 (H2RA) 用者相比,与增加的死亡风险有关. 这凸显了在这个人群中需要仔细考虑PPI的必要性.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 质子抑制剂 (PPI) 在癌症患者的胃酸疾病中经常被处方.
- 新出现的数据表明,长期使用PPI可能与不良健康结果相关,包括死亡率升高.
- 在瘤学人群中PPI的安全性概况需要进一步调查.
研究的目的:
- 评估使用质子抑制剂 (PPI) 与成年癌症患者全因死亡率之间的关联.
- 采用强有力的方法方法,包括倾向性得分匹配,以尽量减少偏见和混因素.
- 为了比较新的PPI使用者,非使用者和组织胺2受体抗剂 (H2RA) 使用者之间的死亡风险.
主要方法:
- 使用来自TriNetX研究网络的电子健康记录进行的回顾性队列研究.
- 新用户,主动比较器设计,将PPI用户与非用户和H2RA用户进行比较.
- 使用1:1倾向分数匹配和多变量考克斯回归模型来分析全因死亡率.
主要成果:
- 与非使用者 (HRs: 2.34-2.72) 和H2RA用户 (HR: 1.51) 相比,PPI使用者表现出明显更高的全因死亡率.
- 敏感性分析,包括排除早期死亡和检查以前的PPI使用者,证实了这些发现.
- 与从未使用过的用户相比,前PPI用户的死亡风险也更高 (HR: 1.84).
结论:
- 质子抑制剂 (PPI) 的使用与癌症患者全因死亡的风险增加有关.
- 研究结果表明,在这个脆弱人群中需要明智的PPI处方.
- 在临床上适合癌症患者时,应考虑替代性胃肠道药物.
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