Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship

doi:10.1007/s12664-023-01428-7

Review

. 2023 Oct;42(5):601-628.

doi: 10.1007/s12664-023-01428-7. Epub 2023 Sep 12.

Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship

Amit Kumar Dutta¹, Abhinav Jain², Vaneet Jearth³, Ramit Mahajan⁴, Manas Kumar Panigrahi⁵, Vishal Sharma³, Mahesh Kumar Goenka⁶, Rakesh Kochhar⁷, Govind Makharia⁸, Duvvur Nageshwar Reddy⁹, Richard Kirubakaran¹⁰, Vineet Ahuja⁸, Neha Berry¹¹, Naresh Bhat¹², Usha Dutta³, Uday Chand Ghoshal¹³, Ajay Jain¹⁴, Umesh Jalihal¹⁵, V Jayanthi¹⁶, Ajay Kumar¹⁷, Sandeep Nijhawan¹⁸, Ujjal Poddar¹³, G N Ramesh¹⁹, Shivram P Singh²⁰, Showkat Zargar²¹, Shobna Bhatia²²

Affiliations

¹ Department of Gastroenterology, Christian Medical College and Hospital, Vellore, 632 004, India. akdutta1995@yahoo.co.in.
² Gastro 1 Hospital, Ahmedabad, 380 060, India.
³ Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
⁴ Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
⁵ All India Institute of Medical Sciences, Bhubaneswar, 751 019, India.
⁶ Apollo Hospital, Kolkata, 700 054, India.
⁷ Paras Hospitals, Panchkula, 134 109, India.
⁸ All India Institute of Medical Sciences, New Delhi, 110 029, India.
⁹ AIG Hospitals, Hyderabad, 500 032, India.
¹⁰ Center of Biostatistics and Evidence Based Medicine, Vellore, 632 004, India.
¹¹ BLK Institute of Digestive and Liver Disease, New Delhi, 201 012, India.
¹² Aster CMI Hospital, Bengaluru, 560 092, India.
¹³ Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226 014, India.
¹⁴ Choithram Hospital and Research Center, Indore, 452 014, India.
¹⁵ Karnataka Gastro Center, Bengaluru, 560 086, India.
¹⁶ Sri Ramachandra Medical College, Chennai, 600 116, India.
¹⁷ Institute of Digestive and Liver Diseases, BLK - Max Superspeciality Hospital, New Delhi, 201 012, India.
¹⁸ Sawai Man Singh Medical College, Jaipur, 302 004, India.
¹⁹ Aster Medcity, Kochi, 682 027, India.
²⁰ Kalinga Gastroenterology Foundation, Cuttack, 753 001, India.
²¹ Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, 190 011, India.
²² Sir H N Reliance Foundation Hospital, Mumbai, 400 004, India.

PMID: 37698821
DOI: 10.1007/s12664-023-01428-7

Review

Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship

Amit Kumar Dutta et al. Indian J Gastroenterol. 2023 Oct.

. 2023 Oct;42(5):601-628.

doi: 10.1007/s12664-023-01428-7. Epub 2023 Sep 12.

Authors

Affiliations

¹ Department of Gastroenterology, Christian Medical College and Hospital, Vellore, 632 004, India. akdutta1995@yahoo.co.in.
² Gastro 1 Hospital, Ahmedabad, 380 060, India.
³ Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
⁴ Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
⁵ All India Institute of Medical Sciences, Bhubaneswar, 751 019, India.
⁶ Apollo Hospital, Kolkata, 700 054, India.
⁷ Paras Hospitals, Panchkula, 134 109, India.
⁸ All India Institute of Medical Sciences, New Delhi, 110 029, India.
⁹ AIG Hospitals, Hyderabad, 500 032, India.
¹⁰ Center of Biostatistics and Evidence Based Medicine, Vellore, 632 004, India.
¹¹ BLK Institute of Digestive and Liver Disease, New Delhi, 201 012, India.
¹² Aster CMI Hospital, Bengaluru, 560 092, India.
¹³ Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226 014, India.
¹⁴ Choithram Hospital and Research Center, Indore, 452 014, India.
¹⁵ Karnataka Gastro Center, Bengaluru, 560 086, India.
¹⁶ Sri Ramachandra Medical College, Chennai, 600 116, India.
¹⁷ Institute of Digestive and Liver Diseases, BLK - Max Superspeciality Hospital, New Delhi, 201 012, India.
¹⁸ Sawai Man Singh Medical College, Jaipur, 302 004, India.
¹⁹ Aster Medcity, Kochi, 682 027, India.
²⁰ Kalinga Gastroenterology Foundation, Cuttack, 753 001, India.
²¹ Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, 190 011, India.
²² Sir H N Reliance Foundation Hospital, Mumbai, 400 004, India.

PMID: 37698821
DOI: 10.1007/s12664-023-01428-7

Abstract

Proton pump inhibitors (PPIs) have been available for over three decades and are among the most commonly prescribed medications. They are effective in treating a variety of gastric acid-related disorders. They are freely available and based on current evidence, use of PPIs for inappropriate indications and duration appears to be common. Over the years, concerns have been raised on the safety of PPIs as they have been associated with several adverse effects. Hence, there is a need for PPI stewardship to promote the use of PPIs for appropriate indication and duration. With this objective, the Indian Society of Gastroenterology has formulated guidelines on the rational use of PPIs. The guidelines were developed using a modified Delphi process. This paper presents these guidelines in detail, including the statements, review of literature, level of evidence and recommendations. This would help the clinicians in optimizing the use of PPIs in their practice and promote PPI stewardship.

Keywords: Adverse effects; Contraindications; Duration; Inappropriate use; Indications; Proton pump inhibitors; Stewardship.

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References

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1. Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017;11:27–37. - PubMed - DOI
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[1] Olbe L, Carlsson E, Lindberg P. A proton-pump inhibitor expedition: the case histories of omeprazole and esomeprazole. Nat Rev Drug Discov. 2003;2:132–9. - PubMed - DOI

[2] Olbe L, Carlsson E, Lindberg P. A proton-pump inhibitor expedition: the case histories of omeprazole and esomeprazole. Nat Rev Drug Discov. 2003;2:132–9. - PubMed - DOI

[3] Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017;11:27–37. - PubMed - DOI

[4] Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017;11:27–37. - PubMed - DOI

[5] Hagymasi K, Mullner K, Herszenyi L, Tulassay Z. Update on the pharmacogenomics of proton pump inhibitors. Pharmacogenomics. 2011;12:873–88. - PubMed - DOI

[6] Hagymasi K, Mullner K, Herszenyi L, Tulassay Z. Update on the pharmacogenomics of proton pump inhibitors. Pharmacogenomics. 2011;12:873–88. - PubMed - DOI

[7] Malfertheiner P, Kandulski A, Venerito M. Proton-pump inhibitors: understanding the complications and risks. Nat Rev Gastroenterol Hepatol. 2017;14:697–710. - PubMed - DOI

[8] Malfertheiner P, Kandulski A, Venerito M. Proton-pump inhibitors: understanding the complications and risks. Nat Rev Gastroenterol Hepatol. 2017;14:697–710. - PubMed - DOI

[9] National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. wwwniceorguk/guidance/cg184 2014;CG184.

[10] National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. wwwniceorguk/guidance/cg184 2014;CG184.

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Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship

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