El omeprazol es uno de los fármacos más consumidos en nuestro país.
Estados Unidos

The famous medication that is related to stomach cancer and that we take daily in the United States

The use and abuse of various drugs, such as omeprazole, has been associated with various risks. However, the evidence in this regard is still questionable.

Leer en español: El famoso medicamento que se relaciona con el cáncer de estómago y que en Estados Unidos tomamos a diario

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One of the most consumed drugs in the United States, alongside paracetamol and anti-inflammatories like ibuprofen, is the well-known omeprazole. The misnamed 'stomach protector' is actually a proton pump inhibitor, in other words, a drug that artificially reduces gastric acid secretion. While it is true that its use is safe when used properly, overuse can be harmful and detrimental, as would be the case with any other drug.

The use of omeprazole has skyrocketed in recent years due to its common consumption as a "protector," although that is not its primary function. Its indication is for esophagitis due to reflux or acid regurgitation, as well as for temporary and limited use in eradicating Helicobacter pylori. However, overuse can be fatal: increased risk of cancer, heart attack, and dementia in the long term.

Excess omeprazole and the risk of cancer

The first time the alarm was raised regarding omeprazole and its possible connection to stomach cancer was in 2017 after a study published in the British Medical Journal (BMJ). In this study, conducted jointly by University College London and the University of Hong Kong, 63,000 people who had received combined treatment with omeprazole and antibiotics for Helicobacter pylori infection were analyzed. Those who received PPIs, like omeprazole, were up to twice as likely to develop gastric cancer.

This study also suggested that those who took omeprazole daily had up to four times the risk of developing gastric cancer, compared to taking it once a week. However, it is important to remember that H. pylori infection alone is associated with an increased risk of stomach cancer, so these results must be interpreted with caution.

Likewise, a more recent meta-analysis published in Alimentary Pharmacology and Therapeutics suggested that there is not enough evidence to confirm this relationship between omeprazole and stomach cancer, although the authors do acknowledge that PPIs are being overused nowadays.

In addition to lingering H. pylori infection, there are other risk factors for stomach cancer, such as chronic inflammation or gastritis, gastroesophageal reflux disease, and gastric polyps. In all these cases, omeprazole or other PPIs are usually recommended, so there is also a possibility that omeprazole may follow the initial cause of cancer, and not be the direct cause itself. This is a topic that is still debated today.

Excess omeprazole and the risk of heart attack

On the other hand, another study warned that consistent use of omeprazole and other PPIs has been associated with a higher risk of stroke or heart attack. At least, that's what a study conducted by Andreana Foresta and colleagues at the Mario Negri Institute of Pharmacological Research in Lombardy (Italy) suggests after studying 280,000 adults with diabetes over 65 years old.

The study, published in the journal Drugs and Aging, suggests that regular intake of omeprazole is associated with up to a 24% higher risk of death, 36% higher risk of heart attack, and 14% higher risk of stroke, after a 6-year follow-up. Similarly, another study published at the end of 2022 suggested that regular use of PPIs increased the risk of cardiovascular events by 27% after monitoring 19,000 people with type 2 diabetes for 11 years.

Once again, these studies have their nuances, as they are observational studies that demonstrate an association but not causality. To date, there are no randomized clinical trials that have detected such causality.

Excess omeprazole and the risk of dementia

Finally, another study published in the journal Neurology analyzed whether constant intake of omeprazole might be linked to dementia. In this case, Carin Northuis and colleagues from the University of Minnesota analyzed 5,712 patients over 5.5 years. Some of them had been taking omeprazole daily for up to 20 years.

According to their data, 585 participants developed dementia, and it was after 4.4 years of consumption prior to the study's baseline (conducted between 2011 and 2013) that a significant increase in risk was detected: between 33% and 42% higher risk.

Once again, causality could not be demonstrated, although the authors state that their work would provide Class III evidence that the use of omeprazole and similar drugs for more than 4.4 years in adults aged 45 or older is associated with a higher incidence of dementia. This is the lowest class of evidence, and these results should be taken with caution, but it sets the stage for further study.

*This article has been automatically translated using artificial intelligence