Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2019; 25(21): 2683-2698
Published online Jun 7, 2019. doi: 10.3748/wjg.v25.i21.2683
Published online Jun 7, 2019. doi: 10.3748/wjg.v25.i21.2683
Association of proton pump inhibitors with risk of hepatic encephalopathy in advanced liver disease: A meta-analysis
Xin-Xing Tantai, Long-Bao Yang, Zhong-Cao Wei, Cai-Lan Xiao, Li-Rong Chen, Jin-Hai Wang, Na Liu, Division of Gastroenterology, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Author contributions: Tantai XX, Wang JH, and Liu N contributed to the study concept and design; Yang LB and Wei ZC contributed to the acquisition of data; Tantai XX, Wang JH, Liu N, Xiao CL, and Chen LR contributed to the analysis and interpretation of data; Tantai XX contributed to the statistical analysis; Tantai XX drafted the manuscript; Wang JH and Liu N contributed to the critical revision of the manuscript for important intellectual content, and study supervision.
Conflict-of-interest statement: The authors have no potential conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Na Liu, PhD, Doctor, Division of Gastroenterology, The Second Affiliated Hospital, Xi’an Jiaotong University, No. 157, Xiwu Road, Xi’an, Shaanxi Province, China. liunafmmu@163.com
Telephone: +86-29-8767-9335 Fax: +86-29-8767-9368
Received: March 12, 2019
Peer-review started: March 13, 2019
First decision: April 11, 2019
Revised: April 21, 2019
Accepted: May 3, 2019
Article in press: May 3, 2019
Published online: June 7, 2019
Peer-review started: March 13, 2019
First decision: April 11, 2019
Revised: April 21, 2019
Accepted: May 3, 2019
Article in press: May 3, 2019
Published online: June 7, 2019
Core Tip
Core tip: Proton pump inhibitors (PPIs) are very commonly used in patients with advanced liver disease. Remarkably, previous studies have shown that approximately 50% of indications for PPIs treatment were unclear or inadequate in this special group of patients. All these may be because PPIs are generally considered safe. However, this meta-analysis shows that using PPIs is associated with an increased risk of hepatic encephalopathy (HE) in patients with advanced liver disease. This reminds clinicians that inappropriate use of PPIs may be not beneficial but put patients at an elevated risk of HE. These findings still need to be confirmed by more high-quality prospective studies because of the limitations of this meta-analysis.