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• W4200333003 abstract "Proton pump inhibitors (PPIs) are one of the most used pharmaceuticals across the globe; thus, its safety is central. The umbrella review presented very recently by Veettil and colleagues1 attempted to grade the certainty of the evidence for the association of PPI exposure and probability of adverse clinical outcomes from meta-analyses including one from us.2 Unfortunately, we noted that there were some inaccurate arguments/judgments made by Veettil and colleagues1 on our previous analysis,2 necessitating careful clarifications. Regarding associations of PPI use with severe outcomes of COVID-19 in our study,2 we found that current or regular use of PPIs was associated significantly with higher risk of severe outcomes of COVID-19, as compared with no use of PPIs, with a pooled OR of 1.67 (95% CI 1.19 to 2.33, p = .003; n = 42 405 patients with COVID-19 from nine studies3-11; I2 = 63%) and a pooled HR of 1.87 (95% CI 1.29 to 2.70, p < .001; n = 2977 patients with COVID-19 from two studies12, 13; I2 = 80%). However, in their tab. 2 by Veettil et al,.1 they argued inappropriately that our analysis on the association between current or regular PPI use and severe COVID-19 outcomes was based on only seven studies of unknown numbers of cases in the “general population,” with a OR of 1.8 (95% CI 1.08–2.97; I2 = 71%). Likewise, in their supplementary tab. S4,1 information on the adjustment for confounding variables collected by Veettil et al.1 from each included meta-analysis was highly misleading. On the one hand, for a specific meta-analysis, adjusted confounding variables across cohort studies could vary substantially, which were not always necessary to be identical, rendering the specification of adjusted confounding variables for a specific meta-analysis instead of a specific cohort study highly unreasonable. On the other hand, regarding our previous analysis, we have already provided the information on confounders adjustment status for every observational study included in our analysis in our supplementary table2 rather than being “not available” argued by Veettil et al.1 Moreover, in their fig. 2 by Veettil et al.,1 they claimed that they “identified a total of 9 associations between the use of PPI and COVID 19 adverse clinical outcomes,” but it was not the case. In their fig. 2, they showed associations on the risk of SARS-CoV-2 infection (also known as susceptibility of COVID-19) from three meta-analyses and one association on duration of hospital stay from one analysis; however, they did not seem to be able to identify these associations on either the risk of SARS-CoV-2 infection or duration of hospital stay from our analysis.2 We therefore believe any results of this umbrella review in relation to the aforementioned arguments should be interpreted with caution." @default.
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• W4200333003 date "2021-12-26" @default.
• W4200333003 modified "2023-09-23" @default.
• W4200333003 title "Use of proton pump inhibitors and adverse clinical outcomes" @default.
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• W4200333003 doi "https://doi.org/10.1111/bcp.15161" @default.
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