Proton pump inhibitor use and risk of hepatic encephalopathy: A multicentre study

• DOI: 10.1016/j.jhepr.2024.101104
• Publication Date: 2024-04-27T01:28:34Z
• Authors: Simon Johannes Ga...; Chiara Mangini; Lisa Zarantonello; Elise Jonasson; Henrike Dobbermann; Philippe Sultanik; Peter Robert Galle; Joachim Labenz; Dominique Thabut; Jens Uwe Marquardt; Patricia P. Bloom; Mette Munk Lauridsen; Sara Montagnese; Christian Labenz
• Keywords: Hepatic Encephalopathy

Background & AimsData on the association between proton pump inhibitor (PPI) use and hepatic encephalopathy (HE) are conflicting, data from multicenter studies scarce. The aim of this study was to dissect potential PPI minimal (MHE) overt HE (OHE).MethodsData patients with cirrhosis recruited at seven centers across Europe US were analyzed. MHE defined by Psychometric Hepatic Encephalopathy Score (PHES). recorded day testing PHES. Patients followed for OHE development death/liver transplantation (LTx).Results1160 a median MELD 11 included (Child-Pugh stages: A 49%/B 39%/C 11%). noted in 58% patients. Median follow-up time 18.1 months, during which 230 (20%) developed an episode, 224 (19%) reached composite endpoint death/LTx. In multivariable analyses, neither associated presence baseline nor follow-up. These findings consistent subgroup analyses Child-Pugh or B after excluding history OHE. also not higher risk OHE, indication treatment without indication.ConclusionsPPI is liver cirrhosis. On basis these findings, prescription should currently be prohibited case generally accepted indication.Impact implicationsData conflicting. study, physician indication.