Patients prescribed direct-acting antivirals (DAAs) for hepatitis C may want to steer clear of proton pump inhibitors like Nexium, after a recently published study suggested the popular heartburn medications could reduce the effectiveness of these treatments.
Published in The Journal of Clinical and Translational Hepatology, the research involved a systemic review and meta-analysis of 9 separate studies involving more than 32,680 patients were being treated with DAAs (Harvoni, Sovaldi, Technivie, Viekera Pak, etc.). The team conducting the research used the earlier studies to compare the effectiveness of the hepatitis C drugs in patients who had taken proton pump inhibitors during treatment and those who had not.
Overall, patients using proton pump inhibitors during DAA treatment were 26% less likely to achieve sustained virologic response compared with non-user. A subgroup analysis indicated that those taking proton pump inhibitors were 32% less likely to achieve a sustained virologic response at 12 weeks. The heartburn medications were also associated with a significantly lower rate of virologic response when the analysis was limited to only those studies that had adjusted for confounders.
“This study demonstrated a significantly increased risk of failure to achieve SVR in HCV-infected patients taking DAA with PPIs compared to non-PPI users,” the paper’s authors concluded. “Providers should consider whether PPI therapy is indicated for patients and withdraw of PPI therapy in the absence of indications, especially while on DAA therapy.”
Proton pump inhibitors like Nexium are used by millions of people to control symptoms associated with GERD and other peptic disorders. The drugs, which are sold by prescription and over-the-counter, are only intended for short-term use. However, some studies have suggested that many patients take the medications for far longer than what is recommended.
In recent years, a growing body of research has suggested that long-term proton pump inhibitor use can have serious health consequences, leading to an increased risk for kidney failure and other renal complications, as well as heart attacks, dementia, bone fractures, vitamin B deficiency, low magnesium levels, and stomach cancer.
Hundreds of plaintiffs who claim to have developed kidney failure, chronic kidney disease, acute kidney injury, and acute interstitial nephritis because of these medications have filed proton pump inhibitor lawsuits in state and federal courts around the country. Among other things, they claim that the drugs’ manufacturers have long concealed evidence linking proton pump inhibitors to serious kidney complications and failed to provide the public with adequate notice of these risks. Plaintiffs further assert that they could have avoided these kidney side effects had they received appropriate warnings from the drugs’ manufacturers.
The majority of proton pump inhibitor lawsuits have been centralized in a federal multidistrict litigation now underway in the U.S. District Court, District of New Jersey. Additional cases have been filed in various state courts, including Delaware, Missouri, Pennsylvania and Louisiana.