medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-17-33-37medalphabet-3849Research ArticleДИАГНОСТИКА И ОНКОТЕРАПИЯDIAGNOSTICS AND ONCOTHERAPYИнгибиторы протонной помпы в онкологической практике: побочные эффекты при длительном применении и лекарственное взаимодействиеPostoperative ileus in obstetric and gynecological practice: a prospective solution to the problemhttps://orcid.org/0000-0002-1597-1876ТруханД. И.TrukhanD. I.

Трухан Дмитрий Иванович - д.м.н., доцент, проф. кафедры поликлинической терапии и внутренних болезней

Омск

Trukhan Dmitry I. - DM Sci (habil.), professor at Dept of Polyclinic therapy and internal diseases.

Omsk

dmitry_trukhan@mail.ruhttps://orcid.org/0000-0003-0385-8232ДеговцовЕ. Н.DegovtsovE. N.

Деговцов Евгений Николаевич-  д.м.н., зав. кафедрой госпитальной хирургии 

Омск

Degovtsov Evgeny N. - DM Sci (habil.), head of Dept of Hospital Surgery

Omsk

edego2001@mail.ruФГБОУ ВО «Омский государственный медицинский университет» Министерства здравоохранения РоссииРоссияOmsk State Medical University of the Ministry of HealthRussian Federation202406092024017«Диагностика и онкотерапия» (2)3337Copyright © Трухан Д.И., Деговцов Е.Н., 20242024Трухан Д.И., Деговцов Е.Н.Trukhan D.I., Degovtsov E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3849

Ингибиторы протонной помпы (ИПП) являются бесспорными лидерами в терапии кислотозависимых заболеваний. В реальной клинической практике в последние десятилетия использование ИПП растет в геометрической прогрессии. Долгое время ИПП считались полностью безопасными лекарственными веществами как для краткосрочного, так и для длительного применения. Однако в современных клинических рекомендациях и обзорах и метаанализах текущего десятилетия, посвященных безопасности применения ИПП, отмечается, что при назначении ИПП в больших дозах на длительный срок следует учитывать возможность развития многочисленных побочных эффектов. Нами проведен поиск в информационных базах PubMed и Scopus публикаций, посвященных безопасности применения ИПП, включавший источники до 01.12.2023. В рамках обзора затронуты вопросы лекарственного взаимодействия ИПП с химиотерапевтическими препаратами, что, безусловно, следует учитывать в реальной клинической практике. Кроме этого, в последних обзорах и метаанализах рассматриваются такие побочные эффекты долгосрочного применения ИПП, как повышенный риск инфекции (инфекция Clostridium difficile, внебольничная пневмония), электролитные нарушения, поражения почек, повышенный риск переломов бедра, запястья и позвонков; повышенный кардиоваскулярный риск и ряд других, которые также могут оказать неблагоприятное влияние на прогноз у онкологических пациентов. Риск развития рака желудка при длительной терапии ИПП можно рассматривать в качестве вероятного побочного эффекта, поскольку наличие их связи с приемом ИПП не отрицается и не подвергается сомнению в последних обзорах и метаанализах. В отношении повышенного риска других онкологических заболеваний еще сохраняется неопределенность, поскольку есть публикации, не подтверждающие наличия их связи с применением ИПП. Однако представленный обзор, несмотря на ряд противоречий, позволяет сделать вывод, что повышенный онкологический риск при длительном применении ИПП реален и его необходимо учитывать при назначении ИПП на длительный срок.

Proton pump inhibitors (PPIs) are the undisputed leaders in the treatment of acid-related diseases. In actual clinical practice, the use of PPIs has been growing exponentially in recent decades. For a long time, PPIs were considered completely safe drugs for both short-term and long-term use. However, modern clinical guidelines and reviews and meta-analyses of the current decade on the safety of PPI use note that when prescribing PPIs in large doses for a long period, the possibility of developing numerous side effects should be taken into account. We searched the PubMed and Scopus information databases for publications on the safety of PPI use, including sources up to 12/01/2023. The review addresses issues of drug interactions between PPIs and chemotherapeutic drugs, which should certainly be taken into account in real clinical practice. In addition, recent reviews and meta-analyses have examined side effects of long-term PPI use, such as increased risk of infection (Clostridium difficile infection, community-acquired pneumonia), electrolyte disturbances, kidney damage, increased risk of hip, wrist and spine fractures; increased cardiovascular risk and a number of others, which can also have an adverse effect on the prognosis of cancer patients. The risk of developing gastric cancer with long-term PPI therapy can be considered as a likely side effect, since their association with PPI use is not denied or questioned in recent reviews and meta-analyses. There is still uncertainty regarding the increased risk of other cancers, since there are publications that do not confirm their association with PPI use. However, the presented review, despite a number of contradictions, allows us to conclude that the increased cancer risk with long-term use of PPIs is real and must be taken into account when prescribing PPIs for a long term.

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The authors declare that there are no conflicts of interest present.