Association between proton pump inhibitor use and mortality in patients with hepatocellular carcinoma receiving tyrosine kinase inhibitor

• Published in: Gut Vol. 70; no. 8; pp. 1598 - 1599
• Main Authors: Wu, Chun-Ying, Ho, Hsiu J, Wu, Chen-Yi, Chen, Yi-Ju, Lee, Teng-Yu, Hsu, Yao-Chun, Lin, Jaw-Town
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.08.2021
• Subjects: Antibiotics; Cancer therapies; Chronic obstructive pulmonary disease; Congestive heart failure; Diabetes mellitus; Hepatitis B; Hepatitis C; Hepatocellular carcinoma; Liver cancer; Liver diseases; Lung cancer; Lung diseases; Metformin; Mortality; Obstructive lung disease; Osteoporosis; Patients; Peptic ulcers; Proton pump inhibitors; Renal failure; Statins; Tumors; Tyrosine kinase inhibitors; Taiwan; proton pump inhibition; hepatoma; antibody targeted therapy
• ISSN: 0017-5749; 1468-3288; 1468-3288
• DOI: 10.1136/gutjnl-2020-321932

Discontinuation was defined as a gap of more than 30 days in TKI use after the index date. Since TKI reimbursement was discontinued by Taiwan NHI in patients with disease progression, TKIs discontinuation was used as a surrogate outcome for tumour progression. IPTW adjustment resulted in less significant differences in most baseline patient characteristics, comorbidities and concomitant drugs use between the PPI and non-PPI cohorts (table 1).Table 1 Demographic characteristics of the study subjects after inverse probability of treatment weighting (IPTW) adjustment Characteristics PPI Non-PPI Difference Difference n=2196 n=8013 Unadjusted Adjusted Age, years 63.664 63.638 −1.10 0.026 Male 79.9% 79.0% 0.035 0.002 Comorbidities  Chronic hepatitis B 87.6% 87.8% −0.010 −0.002  Chronic hepatitis C 35.6% 36.0% −0.017 −0.004  Alcoholic liver diseases 13.1% 12.6% 0.027 0.005  Liver decompensation 20.4% 20.1% 0.098 0.003  Peptic ulcer diseases 61.3% 61.1% 0.180 0.002  Diabetes mellitus 38.4% 37.8% 0.001 0.006  Hypertension 59.3% 58.7% −0.016 0.007  Hypercholesteraemia 17.0% 16.8% −0.007 0.002  Cerebrovascular events 14.4% 14.3% −0.001 0.001  Acute coronary syndrome 23.2% 23.3% −0.005 0.000  Chronic obstructive pulmonary disease 29.3% 29.1% −0.002 0.002  Chronic renal diseases 8.7% 8.3% −0.009 0.004  Osteoporosis 2.4% 2.4% −0.004 −0.001  Bone fracture 27.7% 27.1% 0.002 −0.001  Heart failure 6.2% 6.4% 0.002 −0.002  Liver failure 7.7% 7.6% 0.017 0.002  Renal failure 13.8% 13.5% 0.000 0.003  Vascular invasion 21.0% 20.5% 0.084 0.004 Concomitant drug use  Nucleos(t)ide analogue use 23.% 23.1% 0.032 −0.001  Statins use 4.1% 4.1% −0.004 0.000  Metformin use 11.4% 11.1% −0.006 0l003  Oral antibiotics use 25.7% 25.8% 0.151 −0.001 PPI, proton pump inhibitor. [...]concomitant PPI and TKI use is prevalent and associated with an increased risk of overall mortality in patients with advanced stage HCC.