Possible dementia risk of proton pump inhibitors and H2 receptor blockers use in the treatment of Helicobacter pylori: A meta-analysis study.

INTRODUCTION: The risk of dementia when using proton-pump-inhibitors (PPIs) and H2-receptor-blockers as a treatment of Helicobacter-pylori have a lot of controversial-research with different results; however, no final recommendation was deduced from all these researches. A meta-analysis study was performed to evaluate the relationship between PPIs and H2-receptor-blockers use and dementia.

METHODS: Through a systematic literature search up to December-2019, 10-studies with 371951-subjects of them 71021Helicobacter-pylori-positive subjects using either PPIs or H2-receptor-blockers or both were identified reporting-relationships between PPIs and H2-receptor-blockers uses and dementia (10-studies contained PPIS, 4-contained H2-receptor-blockers). Odd-ratio (OR) with 95% confidence-intervals (CIs) was calculated comparing PPIs and H2-receptor-blockers users and to non-user subjects on the bases of dementia using the dichotomous-method with a random-effect-model.

RESULTS: No significant difference was found between PPIs-users or non-user (OR, 0.87; 95% CI, 0.62-1.22) or between H2-receptor blockers-users and non-users (OR, 1.21; 95% CI, 0.91-1.59) as a risk of dementia. The extent of increases in dementia with H2-receptor-blockers was higher than that with PPIs. The impact of PPIs and H2-receptor-blockers was similar in all populations.

CONCLUSIONS: Based on this meta-analysis, the contentious use of PPIs or H2-receptor-blockers may not have an independent-relationship to dementia. This suggests that using PPIs or H2-receptor-blockers is not related to dementia. However, we still have to recommend careful use of PPIs and H2-receptor-blockers when treating Helicobacter-pylori and sticking to the dose and length of treatment and not to extend it to avoid any possible risk.