Encouraging appropriate use of proton pump inhibitors: existing initiatives and proposals for the future

Amir Mari, Elisa Marabotto, Mentore Ribolsi, Fabiana Zingone, Brigida Barberio, Vincenzo Savarino, Edoardo Vincenzo Savarino

Research output: Contribution to journalComment/debate

1 Scopus citations

Abstract

Introduction: Proton pump inhibitors (PPIs) have revolutionized the management of acid-related disorders, representing today the mainstay treatment of these conditions. However, despite their large range of indications and usefulness, the remarkable expansion of their use in the last two decades cannot be explained by the increasing prevalence of acid-related diseases only. An inappropriate prescription for clinical conditions in which the pathogenetic role of acid has not been documented has been described, with the natural consequence of increasing the costs and the potential risk of iatrogenic harm due to adverse events and complications recently emerged. Areas covered: In this review, we summarize current indications of PPIs administration, potential adverse events associated with their chronic utilization, and misuse of PPIs. Moreover, we describe existing and possible initiatives for improving the use of PPIs, and some proposals for the future. Expert opinion: PPI deprescribing is the preferred and most effective approach to reduce the use of PPIs, rather than adopting sharp discontinuation, probably due to fewer withdrawal symptoms. Nonetheless, large knowledge gaps still exist in clinical practice regarding the optimal approach of PPI deprescribing in various clinical scenarios. Further prospective well-designed international studies are eagerly warranted to improve our perspectives on controlling global PPI inappropriate use.

Original languageEnglish
Pages (from-to)913-923
Number of pages11
JournalExpert Review of Clinical Pharmacology
Volume16
Issue number10
DOIs
StatePublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • GERD
  • PPI
  • Proton pump inhibitors
  • acid-suppressive therapy
  • misuse

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