Evidence map›Paper›PMID 39035069›Full record

ArticleJHEP reports : innovation in hepatology2024

Proton pump inhibitor use and risk of hepatic encephalopathy: A multicentre study.

Simon Johannes Gairing, Chiara Mangini, Lisa Zarantonello, Elise Jonasson, Henrike Dobbermann, Philippe Sultanik, Peter Robert Galle, Joachim Labenz, Dominique Thabut, Jens Uwe Marquardt and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JHEP reports : innovation in hepatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Use of Proton Pump Inhibitors Among Patients With Alcohol-Related Cirrhosis-A Danish Nationwide Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
  3. Acute-on-Chronic Liver Failure: Steps Towards Consensus.Diagnostics (Basel, Switzerland) · 2025
    Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Simon Johannes GairingDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Chiara ManginiDepartment of Medicine, University of Padova, Padova, Italy.
Lisa ZarantonelloDepartment of Medicine, University of Padova, Padova, Italy.
Elise JonassonDepartment of Gastroenterology and Hepatology, Hospital of South West Jutland, Esbjerg, Denmark.
Henrike DobbermannDepartment of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany.
Philippe SultanikService d'hépato-gastroentérologie, Sorbonne Université, Hôpital Pitié-Salpêtrière Assistance Publique Hôpitaux de Paris, Paris, France.
Peter Robert GalleDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Joachim LabenzDepartment of Medicine, Diakonie Hospital Jung-Stilling, Siegen, Germany.
Dominique ThabutService d'hépato-gastroentérologie, Sorbonne Université, Hôpital Pitié-Salpêtrière Assistance Publique Hôpitaux de Paris, Paris, France.
Jens Uwe MarquardtDepartment of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany.
Patricia P BloomDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, United States.
Mette Munk LauridsenDepartment of Gastroenterology and Hepatology, Hospital of South West Jutland, Esbjerg, Denmark.
Sara MontagneseDepartment of Medicine, University of Padova, Padova, Italy.
Christian LabenzDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background & Aims: Data on the association between proton pump inhibitor (PPI) use and hepatic encephalopathy (HE) are conflicting, and data from multicentre studies are scarce. The aim of this study was to dissect the potential association between PPI use and minimal (MHE) and overt HE (OHE). Methods: Data from patients with cirrhosis recruited at seven centres across Europe and the US were analysed. MHE was defined by the psychometric hepatic encephalopathy score (PHES). PPI use was recorded on the day of testing with PHES. Patients were followed for OHE development and death/liver transplantation. Results: A total of 1,160 patients with a median MELD of 11 were included (Child-Pugh stages: A 49%/B 39%/C 11%). PPI use was noted in 58% of patients. Median follow-up time was 18.1 months, during which 230 (20%) developed an OHE episode, and 224 (19%) reached the composite endpoint of death/liver transplantation. In multivariable analyses, PPI use was neither associated with the presence of MHE at baseline nor OHE development during follow-up. These findings were consistent in subgroup analyses of patients with Child-Pugh A or B cirrhosis and after excluding patients with a history of OHE. PPI use was also not associated with a higher risk of OHE, neither in patients with an indication for treatment nor in patients without an indication. Conclusions: PPI use is not associated with a higher risk of HE in patients with cirrhosis. Based on these findings, at present, a prescription should not be prohibited in case of a generally accepted indication. Impact and implications: Data on the association between proton pump inhibitor (PPI) use and hepatic encephalopathy (HE) are conflicting. In this study, PPI use was not associated with a higher risk of minimal HE at baseline or overt HE during follow-up in patients with cirrhosis. Based on these findings, prescription of a PPI for a generally accepted indication should not be prohibited in patients with cirrhosis.

Indexed as

Acid suppressionCovert hepatic encephalopathyDecompensated cirrhosisPsychometric hepatic encephalopathy score

Identifiers

PMID39035069
PMCPMC11260370

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.