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Long-term use of proton pump inhibitors among community-dwelling persons with and without Alzheimer’s disease

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

The aim of this study is to determine the prevalence of use and long-term use (≥180 days) of proton pump inhibitors (PPIs) and associated factors among community-dwellers with and without Alzheimer’s disease (AD).

Methods

MEDALZ cohort encompassed all persons who received a verified diagnosis of AD in Finland during the years 2005–2011 and their age-, sex-, and region of residence-matched comparison persons, including 69,353 persons with and 69,353 persons without AD. Data was derived from several Finnish administrative registers. A mathematical modelling method, PRE2DUP, was used for converting dispensing data to drug use periods (when regular PPI use started and ended). Morbid conditions and concomitant drugs associated with use and long-term use of PPIs were assessed with logistic regression models.

Results

Use of PPIs was more common among comparison persons than persons with AD (39.0 and 35.8%, respectively, p < 0.001), whereas long-term use of PPIs was more frequent among persons with than without AD (20.3 and 17.9%, respectively, p < 0.001). Factors related to long-term use of PPIs were female sex, history of gastrointestinal bleedings, AD, rheumatoid arthritis, cardiovascular disease, asthma/COPD and use of bisphosphonates, SSRIs and antithrombotic agents. Median follow-up time was 2.6 years among persons with AD and 3.5 years among persons without AD. Median duration of the first long-term PPI use was similar in both groups (1.4 years).

Conclusion

Long-term use of PPIs was common among persons with and without AD. Due to possible adverse events associated with the long-term use of PPIs, need for PPIs should be assessed regularly.

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Author information

Authors and Affiliations

  1. Kuopio Research Centre of Geriatric Care, University of Eastern Finland, P.O.B 1627, -70211, Kuopio, FI, Finland

    Heidi Juntunen, Heidi Taipale, Anna-Maija Tolppanen, Sirpa Hartikainen & Miia Tiihonen

  2. School of Pharmacy, University of Eastern Finland, P.O.B 1627, -70211, Kuopio, FI, Finland

    Heidi Juntunen, Heidi Taipale, Anna-Maija Tolppanen, Sirpa Hartikainen & Miia Tiihonen

  3. Department of Clinical Neuroscience, Karolinska Institutet, -171 77, Stockholm, SE, Sweden

    Heidi Taipale, Antti Tanskanen & Jari Tiihonen

  4. Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Niuvankuja 65, FI-70240, Kuopio, Finland

    Antti Tanskanen & Jari Tiihonen

Authors
  1. Heidi Juntunen
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  2. Heidi Taipale
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  3. Antti Tanskanen
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  4. Anna-Maija Tolppanen
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  5. Jari Tiihonen
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  6. Sirpa Hartikainen
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  7. Miia Tiihonen
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Contributions

HJ analysed data and wrote the paper. All authors contributed on study design and commented on and edited the article.

Corresponding author

Correspondence to Miia Tiihonen.

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Funding

None received for this study.

Conflict of interest

SH has received lecture fees from MSD and Professio. HT, JT and AT have participated in research projects funded by Janssen and Eli Lilly with grants paid to the institution where they were employed. AT is a member of Janssen advisory board. JT has served as a consultant to Lundbeck, Organon, Janssen-Cilag, Eli Lilly, AstraZeneca, F. Hoffman-La Roche and Bristol-Myers Squibb. He has received fees for giving expert opinions to Bristol-Myers Squibb and GlaxoSmithKline, lecture fees from Janssen-Cilag, Bristol-Myers Squibb, Eli Lilly, Pfizer, Lundbeck, GlaxoSmithKline, AstraZeneca and Novartis; and grant from Stanley Foundation. JT is a member of advisory board in AstraZeneca, Janssen-Cilag and Otsuka. Other authors declare no conflicts of interest.

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Juntunen, H., Taipale, H., Tanskanen, A. et al. Long-term use of proton pump inhibitors among community-dwelling persons with and without Alzheimer’s disease. Eur J Clin Pharmacol 73, 1149–1158 (2017). https://doi.org/10.1007/s00228-017-2273-8

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  • DOI: https://doi.org/10.1007/s00228-017-2273-8

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