proton pump inhibitors (PPIs) in liver cirrhosis

Last edited 05/2022 and last reviewed 01/2023

Proton pump inhibitors in liver cirrhosis

  • Mahmud et al undertook a study to evaluate the association between PPI (proton pump inhibitor) exposure and all-cause mortality, infection, and decompensation in cirrhotic patents
    • PPI exposure is associated with increased risk of infection and decompensation in cirrhosis, which may mediate liver-related mortality
    • however, PPI use was associated with reduced all-cause mortality in those with prior gastrointestinal bleeding, suggesting benefit in the presence of an appropriate indication
  • results from Mahmud et al overall show that "..exposure to PPIs, although it may be related to a greater risk of decompensation and infection, can have a protective effect in terms of survival if prescribed according to appropriate indications. Interestingly, the daily dose and the cumulative dose of PPIs exposure assume a key role in assessing the outcomes of cirrhotic patients. Therefore, as recommended elsewhere, PPIs should only be prescribed where appropriate and at the minimum dose necessary for an adequate effect..." (2)