SAFETY OF LONG TERM OMEPRAZOLE

Omeprazole is one of the most widely prescribed medications, being used both for the symptomatic treatment of gastro-oesophageal reflux and also to prevent NSAID associated peptic ulcer. The results of the recent survey of mortality in 18 000 people treated with omeprazole is therefore of great interest. While there is a modest increase in mortality from circulatory, respiratory, and musculoskeletal disorders in the first year after initiating treatment, this fell to the expected level by year 4, strongly suggesting that the observed increased mortality was due more to the underlying disease for which omeprazole was prescribed, than the drug itself. A different pattern was observed in neoplasmas of the oesophagus and cirrhosis, conditions which both showed a continuing excess over a period of four years from commencing treatment. When examined more closely, the risk for oesophageal cancer was only increased in those with Barrett’s oesophagus, a condition known to be pre-malignant. This strongly suggests that the excess mortality in this group is due to the underlying …