Do PPIs Protect Against Upper GI Bleeding in Patients Taking Warfarin?

Proton-pump inhibitors reduced upper gastrointestinal bleeding, but by a significant amount only in patients also taking NSAIDs or antiplatelet agents.

Proton-pump inhibitors (PPIs) reduce the risk for upper gastrointestinal bleeding (UGIB) in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents (APAs). To assess the impact of PPIs on bleeding in patients taking warfarin, investigators performed a retrospective cohort study involving 97,430 patients in the Tennessee Medicaid database and the 5% National Medicare sample who were newly prescribed warfarin.

Analysis of 75,720 patient-years of follow-up data showed the following:

The rate of hospitalizations for UGIB (a primary endpoint) was lower by 24% in patients taking PPIs versus those not taking PPIs (adjusted hazard ratio, 0.76; 95% confidence interval, 0.63–0.91).
In patients also taking NSAIDs or APAs, th…

Reviewing Author

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose

Do PPIs Protect Against Upper GI Bleeding in Patients Taking Warfarin?

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Reviewing Author