Digestive Tract Cancer Related Adverse Events Associated with Proton
Pump Inhibitors use: A Pharmacovigilance Study of the FDA Adverse Event
Reporting System
Abstract
Background Proton pump inhibitors (PPIs) are widely used to
treat digestive system diseases. Previous studies have suggested
conflicting results between PPIs treatment and digestive tract cancers
(DTCs). We utilized the FDA Adverse Event Reporting System (FAERS)
database to assess the effect of PPIs use on DTCs through data mining.
Method This study examined the association between six PPI
agents and DTCs by mining the FAERS database from January 2004 to
September 2021 by using Open Vigil 2.1. The reporting odds ratio (ROR)
with 95% confidence intervals (CIs) was used to detect statistically
significant associations between PPIs and DTCs. High Level Terms (HLTs)
and Preferred Terms (PTs) were defined by the Medical Dictionary for
Regulatory Activities 24.0 (MedDRA24.0). Result A total of 2553
DTCs adverse event reports were screened, with positive signals obtained
from gastric neoplasms malignant (GNM) (ROR: 1.09, 95% CI: 1.01-1.18)
and bile duct neoplasms malignant (BDNM) (ROR: 1.80, 95% CI:
1.44-2.25). Esomeprazole showed the strongest signal (ROR: 1.85, 95%
CI: 1.66-2.06) for GNM, while rabeprazole for BDNM (ROR: 2.94, 95% CI:
1.32-6.56), and female PPI users had a higher risk of BDNM (ROR: 2.44,
95% CI: 1.77-3.35). Among Subordinate PTs, adenocarcinoma gastric, and
the combination of “bile duct cancer” and “cholangiocarcinoma” were
highly associated with PPIs use. Conclusion By mining the FAERS
database, we provided important clues for the association between PPIs
use and DTCs risk.