Uso de inibidores da bomba de prótons e desenvolvimento da doença de Alzheimer (DA): uma revisão da literatura

Abstract

Introduction. In the late 20th century, proton pump inhibitors (PPIs) began to be marketed as part of the treatment and prevention of gastrointestinal diseases, such as ulcers, gastritis and gastroesophageal reflux (GERD), with the promise of complete and long-lasting acid suppression that allows use in a single daily dose. Since then, they have become some of the most prescribed agents in outpatient and inpatient settings worldwide. However, safety concerns have arisen regarding the use of proton pump inhibitors (PPIs) based on the risk of dementia, mainly Alzheimer's disease (AD), due to possible side effects occurring after crossing the blood-brain barrier or due to the possibility of these drugs impairing the absorption of vitamin B12 and iron. Objective. To review the most recent scientific literature to establish a possible relationship between the use of PPIs and the increased risk of developing Alzheimer's disease (AD). Methodology. The electronic databases of PubMed, ScieLO, and Google Scholar were searched, where studies published in the last 6 years were selected, limited to randomized clinical trials (RCTs), systematic reviews, meta-analyses, and pertinent cohort studies. The aim was to synthesize the evidence accumulated over this period. Results. Ten articles were included in this review, five of which were systematic reviews, two were meta-analyses, one was a randomized, double-blind clinical trial, and two were cohort studies, which presented the relative risk of PPI use in relation to the development of Alzheimer's disease (AD) and in relation to vitamin B12 and iron deficiency generated by the chronic use of this class of drugs. Conclusion. In summary, no statistically significant or clinically significant association was found between the use of PPIs and the development of dementia from all known causes or Alzheimer's disease (AD) specifically. Overall, the evidence was classified as very low quality.