Literature analysis of hematological adverse reactions of proton pump inhibitors
Objective To explore the characteristics of hematologic ADRs associated with proton pump inhibitors(PPIs),providing reference for clinical rational drug use.Methods Case reports of hematologic ADRs related to PPIs were retrieved from PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang database,VIP database,and China Biomedical Literature Database(CBM)from database inception to July 1,2023.General patient information,clinical diagnosis,medication details,ADR occurrence time and clinical manifestations,management,and outcomes were recorded and analyzed.General patient condition,clinical diagnosis,medication details,ADR occurrence time and clinical manifestations,management and outcomes were recorded and analyzed.Results A total of 42 articles involving 45 patients were ultimately included in the study,with 23 males(51.1%)and 22 females(48.9%).The distribution of PPIs associated with hematologic ADRs from most to least cases was:omeprazole 18 cases(40.0%),pantoprazole 14 cases(31.1%),lansoprazole 6 cases(13.3%),esomeprazole 4 cases(8.9%),and rabeprazole 3 cases(6.7%).The main manifestations of hematologic ADRs included decreases in platelet count,white blood cell count,neutrophil count,and hemoglobin.ADRs most commonly occurred within 7 days of medication use and generally lasted no longer than 7 days.Among the 45 patients,26(57.8%)were managed by drug discontinuation alone,7(15.6%)switched to other acid suppressants after discontinuation,and 12(26.7%)were treated with drug discontinuation and symptomatic treatment.Among the 45 patients,26 cases(57.8%)only took the measures of drug withdrawal,7 cases(15.6%)changed to other acid suppressants after drug withdrawal,and 12 cases(26.7%)discontinued the medication and received symptomatic treatment.21(46.7%)patients improved after drug withdrawal or symptomatic treatment,and 24(53.3%)patients were cured.Conclusion Patients need to undergo regular blood count monitoring during the use of PPIs.If ADRs are detected,medication should be discontinued immediately.Anemia or persistent symptoms after discontinuation should be treated promptly with appropriate symptomatic measures.
proton pump inhibitorshematologic systemadverse drug reactionliterature analysis
万方数据
维普
