Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model
Background: Dementia has a crucial impact on the quality of life of elderly patients and their caregivers. Proton-pump inhibitors (PPIs) are the most frequently prescribed treatment, but they have been shown to be associated with dementia. The data are inconsistent, however. Objective: To investigat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-11-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/17562864221135700 |
| _version_ | 1798022892046254080 |
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| author | Yerim Kim Seung In Seo Kyung Joo Lee Jinseob Kim Jong Jin Yoo Won-Woo Seo Hyung Seok Lee Woon Geon Shin |
| author_facet | Yerim Kim Seung In Seo Kyung Joo Lee Jinseob Kim Jong Jin Yoo Won-Woo Seo Hyung Seok Lee Woon Geon Shin |
| author_sort | Yerim Kim |
| collection | DOAJ |
| description | Background: Dementia has a crucial impact on the quality of life of elderly patients and their caregivers. Proton-pump inhibitors (PPIs) are the most frequently prescribed treatment, but they have been shown to be associated with dementia. The data are inconsistent, however. Objective: To investigate the association between PPIs use and Alzheimer’s disease (AD) or all-cause dementia in six observational Korean databases using a Common Data Model (CDM) and to perform a distributed network analysis. Methods: Subjects aged over 18 years between 1 January 2004 and 31 December 2020. Among 7,293,565 subjects from 6 cohorts, 41,670 patients met the eligibility criteria. A total of 2206 patients who were included in both cohorts or with a history of dementia were excluded. After propensity matching, 5699 propensity-matched pairs between the PPIs and histamine-2 receptor antagonist (H 2 RA) users were included in this study. The primary outcome was the incidence of AD at least 365 days after drug exposure. The secondary outcome was the incidence of all-cause dementia at least 365 days after drug exposure. Results: In the 1:1 propensity score matching, the risk of AD or all-cause dementia was not significantly different between the PPIs and H 2 RA groups in all six databases. In the distributed network analysis, the long-term PPI users (⩾365 days) were unassociated with AD [hazard ratio (HR) = 0.92, 95% confidence interval (CI) = 0.68–1.23; I 2 = 0%] and all-cause dementia (HR =1.04, 95% CI = 0.82–1.31; I 2 = 0%) compared with H 2 RA users. Conclusion: In the distributed network analysis of six Korean hospital databases using Observational Medical Outcomes Partnership (OMOP)-CDM data, the long-term use of PPI was not associated with a statistically significantly increased risk of AD or all-cause dementia. Therefore, we suggest that physicians should not avoid these medications because of concern about dementia risk. |
| first_indexed | 2024-04-11T17:37:23Z |
| format | Article |
| id | doaj.art-0e7d0c6d41994c5fb596b5626745966b |
| institution | Directory Open Access Journal |
| issn | 1756-2864 |
| language | English |
| last_indexed | 2024-04-11T17:37:23Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj.art-0e7d0c6d41994c5fb596b5626745966b2022-12-22T04:11:35ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642022-11-011510.1177/17562864221135700Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data ModelYerim KimSeung In SeoKyung Joo LeeJinseob KimJong Jin YooWon-Woo SeoHyung Seok LeeWoon Geon ShinBackground: Dementia has a crucial impact on the quality of life of elderly patients and their caregivers. Proton-pump inhibitors (PPIs) are the most frequently prescribed treatment, but they have been shown to be associated with dementia. The data are inconsistent, however. Objective: To investigate the association between PPIs use and Alzheimer’s disease (AD) or all-cause dementia in six observational Korean databases using a Common Data Model (CDM) and to perform a distributed network analysis. Methods: Subjects aged over 18 years between 1 January 2004 and 31 December 2020. Among 7,293,565 subjects from 6 cohorts, 41,670 patients met the eligibility criteria. A total of 2206 patients who were included in both cohorts or with a history of dementia were excluded. After propensity matching, 5699 propensity-matched pairs between the PPIs and histamine-2 receptor antagonist (H 2 RA) users were included in this study. The primary outcome was the incidence of AD at least 365 days after drug exposure. The secondary outcome was the incidence of all-cause dementia at least 365 days after drug exposure. Results: In the 1:1 propensity score matching, the risk of AD or all-cause dementia was not significantly different between the PPIs and H 2 RA groups in all six databases. In the distributed network analysis, the long-term PPI users (⩾365 days) were unassociated with AD [hazard ratio (HR) = 0.92, 95% confidence interval (CI) = 0.68–1.23; I 2 = 0%] and all-cause dementia (HR =1.04, 95% CI = 0.82–1.31; I 2 = 0%) compared with H 2 RA users. Conclusion: In the distributed network analysis of six Korean hospital databases using Observational Medical Outcomes Partnership (OMOP)-CDM data, the long-term use of PPI was not associated with a statistically significantly increased risk of AD or all-cause dementia. Therefore, we suggest that physicians should not avoid these medications because of concern about dementia risk.https://doi.org/10.1177/17562864221135700 |
| spellingShingle | Yerim Kim Seung In Seo Kyung Joo Lee Jinseob Kim Jong Jin Yoo Won-Woo Seo Hyung Seok Lee Woon Geon Shin Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model Therapeutic Advances in Neurological Disorders |
| title | Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model |
| title_full | Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model |
| title_fullStr | Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model |
| title_full_unstemmed | Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model |
| title_short | Long-term use of proton-pump inhibitor on Alzheimer’s disease: a real-world distributed network analysis of six observational Korean databases using a Common Data Model |
| title_sort | long term use of proton pump inhibitor on alzheimer s disease a real world distributed network analysis of six observational korean databases using a common data model |
| url | https://doi.org/10.1177/17562864221135700 |
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