Effect of long-term proton pump inhibitor administration on gastric mucosal atrophy: A meta-analysis

• Main Authors: Zhong Li, Cong Wu, Ling Li, Zhaoming Wang, Haibin Xie, Xiaozhou He, Jin Feng
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: The Saudi Journal of Gastroenterology
• Subjects: Gastric atrophy; meta-analysis; proton pump inhibitors
• Online Access: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2017;volume=23;issue=4;spage=222;epage=228;aulast=Li
• ISSN: 1319-3767; 1998-4049

Background/Aims: Proton pump inhibitors (PPIs) are widely used for the treatment of acid-related gastrointestinal diseases. Recently, some studies have reported that PPIs can alter the gastric mucosal architecture; however, the relationship remains controversial. This meta-analysis study was designed to quantify the association between long-term PPI administration and gastric atrophy. Materials and Methods: A PubMed search was conducted to identify studies using the keywords proton pump inhibitors or PPI and gastric atrophy or atrophic gastritis; the timeframe of publication searched was up to May 2016. Heterogeneity among studies was tested with the Q test; odds ratios (OR) and 95% confidence intervals (CI) were calculated. P values were calculated by I2 tests and regarded as statistically significant when <0.05. Results: We identified 13 studies that included 1465 patients under long-term PPI therapy and 1603 controls, with a total gastric atrophy rate of 14.50%. There was a higher presence of gastric atrophy (15.84%; statistically significant) in PPI group compared to the control group (13.29%) (OR: 1.55, 95% CI: 1.00–2.41). Conclusions: The pooled data suggest that long-term PPI use is associated with increased rates of gastric atrophy. Large-scale multicenter studies should be conducted to further investigate the relationship between acid suppressants and precancerous diseases.