The study looked at a popular class of antacid medications called Proton Pump Inhibitors (PPIs), which are sold under brand-names like Nexium, Prilosec, Zegerid, Aciphex, Dexilant, as well as generics.
The researchers compared the risk of death from PPIs to another class of heartburn drugs called H2-receptor agonists (H2-blockers), which includes Pepcid, Zantac, Tagamet, and generics.
Overall, they found that people who used PPIs long-term were 25% more likely to die than people who used H2-blockers. Furthermore, the risk of death increased over time. People who used a PPI for 1-2 years were 50% more likely to die than people who used H2-blockers.
The conclusions were based on data from U.S. military veterans over a median follow-up of 5.71 years, including 276,000 veterans on PPIs and 75,000 on H2-blockers, between October 2006 and September 2008. The database did not have information on the cause of death.
According to senior author Dr. Ziyad Al-Aly:
When we compared patients taking H2 blockers with those taking PPIs for 1 to 2 years, we found those on PPIs had a 50% increased risk of dying over the next 5 years.”
Dr. Al-Aly said people believe PPIs are safe because they are sold over-the-counter, but there are real risks — especially when heartburn drugs are taken for long periods of time.
He estimated 1 extra death that would not have otherwise occurred for every 500 people who take a PPI for a year. Because over 15 million Americans are on Nexium alone, the excess risk could translate to thousands of deaths per year, he said.
The conclusions are consistent with other studies linking long-term use of PPIs with higher rates of many diseases, including kidney failure, stroke, dementia, and infections with the antibiotic-resistant suberbug C. difficile.
The findings were published in the the journal BMJ Open by researchers at the U.S. Department of Veterans Affairs and Washington University School of Medicine in St. Louis, Missouri.