ArticleBMJ (Clinical research ed.)2019
Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 9 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
102 citing papers in PubMed, 9 syntheses or guidelines pooled it, 238 citations in OpenAlex.
- The association between proton pump inhibitor use and the risk of mortality in patients with kidney disease: a systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Proton pump inhibitors associated with an increased risk of mortality in elderly: a systematic review and meta-analysis.European journal of clinical pharmacology · 2024Pooled it
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Efficacy and safety of concomitant use of proton pump inhibitors with aspirin-clopidogrel dual antiplatelet therapy in coronary heart disease: A systematic review and meta-analysis.Frontiers in pharmacology · 2022Pooled it
- Regular use of proton-pump inhibitors and risk of stroke: a population-based cohort study and meta-analysis of randomized-controlled trials.BMC medicine · 2021Pooled it
- Proton pump inhibitor on susceptibility to COVID-19 and its severity: a systematic review and meta-analysis.Pharmacological reports : PR · 2021Pooled it
- Acid-suppressive agents and survival outcomes in patients with cancer: a systematic review and meta-analysis.International journal of clinical oncology · 2021Pooled it
- Do proton pump inhibitors increase mortality? A systematic review and in-depth analysis of the evidence.Pharmacology research & perspectives · 2020Pooled it
- Proton pump inhibitors and risk of liver cancer and mortality in patients with chronic liver disease: a systematic review and meta-analysis.European journal of clinical pharmacology · 2020Pooled it
- Five-year clinical outcomes of RefluxStop surgery in the treatment of acid reflux: a prospective multicenter trial of safety and effectiveness.Surgical endoscopy · 2025Trial
- Impact of proton pump inhibitors on efficacy of antiplatelet strategies with ticagrelor or aspirin after percutaneous coronary intervention: Insights from the GLOBAL LEADERS trial.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2022Trial
- The Mortality Risk of Proton Pump Inhibitors in 1.9 Million US Seniors: An Extended Cox Survival Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Trial
- Guidelines for the prevention and treatment of stress ulcers in critically ill patients (2026).Journal of intensive medicine · 2026Article
- Impact of concomitant proton pump inhibitors in patients treated for advanced or metastatic NSCLC: a target trial emulation protocol.ESMO real world data and digital oncology · 2026Article
- From study design to executable code: automating target trial emulation with large language models.JAMIA open · 2026Article
- Safety outcomes in 602 GERD patients treated by RefluxStop: a multi-center real-world study from 22 centers across six European countries.Scientific reports · 2026Article
- Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Bone health, renal outcomes, and iron deficiency anaemia in proton pump inhibitor versus histamine-2 receptor antagonist users: a retrospective cohort study based on TriNetX global collaborative network data.BMJ open gastroenterology · 2025Article
- Proton pump inhibitors and all-cause mortality in colorectal cancer.Scientific reports · 2025Article
42 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate all cause mortality and cause specific mortality among patients taking proton pump inhibitors (PPIs).
designLongitudinal observational cohort study.
settingUS Department of Veterans Affairs.
participantsNew users of PPIs (n=157 625) or H2 blockers (n=56 842).
main outcome measuresAll cause mortality and cause specific mortality associated with taking PPIs (values reported as number of attributable deaths per 1000 patients taking PPIs).
resultsThere were 45.20 excess deaths (95% confidence interval 28.20 to 61.40) per 1000 patients taking PPIs. Circulatory system diseases (number of attributable deaths per 1000 patients taking PPIs 17.47, 95% confidence interval 5.47 to 28.80), neoplasms (12.94, 1.24 to 24.28), infectious and parasitic diseases (4.20, 1.57 to 7.02), and genitourinary system diseases (6.25, 3.22 to 9.24) were associated with taking PPIs. There was a graded relation between cumulative duration of PPI exposure and the risk of all cause mortality and death due to circulatory system diseases, neoplasms, and genitourinary system diseases. Analyses of subcauses of death suggested that taking PPIs was associated with an excess mortality due to cardiovascular disease (15.48, 5.02 to 25.19) and chronic kidney disease (4.19, 1.56 to 6.58). Among patients without documented indication for acid suppression drugs (n=116 377), taking PPIs was associated with an excess mortality due to cardiovascular disease (22.91, 11.89 to 33.57), chronic kidney disease (4.74, 1.53 to 8.05), and upper gastrointestinal cancer (3.12, 0.91 to 5.44). Formal interaction analyses suggested that the risk of death due to these subcauses was not modified by a history of cardiovascular disease, chronic kidney disease, or upper gastrointestinal cancer. Taking PPIs was not associated with an excess burden of transportation related mortality and death due to peptic ulcer disease (as negative outcome controls).
conclusionsTaking PPIs is associated with a small excess of cause specific mortality including death due to cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer. The burden was also observed in patients without an indication for PPI use. Heightened vigilance in the use of PPI may be warranted.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.