A Multi-national Survey to Identify Clinicians’ Perspectives Concerning Proton Pump Inhibitors in Patients With Systemic Sclerosis

Authors

• Giulia Bandini
• Alessia Alunno
• Filipe Oliveira Pinheiro
• Corrado Campochiaro
• Ilaria Galetti
• Pietro Matucci Cerinic
• Barbara Ruaro
• Alberto Moggi Pignone
• Silvia Bellando Randone
• Lorenzo Dagna
• Marco Matucci Cerinic
• Zsuzsanna H McMahan
• Michael Hughes

Language

English

Publication Date

8-1-2024

Journal

Seminars in Arthritis and Rheumatism

DOI

10.1016/j.semarthrit.2024.152419

PMID

38430623

Abstract

Objectives: Proton Pump Inhibitors (PPIs) are widely used in SSc for gastroesophageal reflux disease (GERD). However, there is little evidence to support their empirical use and long-term safety has been questioned. Our objective was to better describe clinicians' attitudes toward PPIs prescription and use in SSc patients.

Methods: Clinicians involved in the care of SSc patients were invited through international physician networks and social media to participate in an online survey.

Results: Responses from 227 clinicians from 36 countries were evaluable. The majority 'agreed' (41.4 %) or 'strongly agreed' (45.4 %) that GERD is a major cause of morbidity in SSc. Lifestyle modifications are seldom (16 %) considered effective. Only half 'agreed' (43 %) or 'strongly agreed' (11 %) there is solid evidence supporting PPIs efficacy in SSc. The most common reasons for PPIs prescription were symptomatic GERD unresponsive to lifestyle modification (95 %), objective evidence of GERD (82 %), and hoarseness or respiratory symptoms (71 %). There are variable concerns about PPIs long-term safety in SSc. The three highest (mean) reasons (0-10, here 10 is 'very concerned') were: small intestinal bacterial overgrowth (5.5), osteoporosis (5.4), and drug interactions (5.2). There are significant differences in attitudes towards surgery for refractory GERD, and concerns about potential complications. PPIs may have a putative role for disease modification (e.g., ILD and calcinosis), and the role of immunosuppression is uncertain for GI (gastrointestinal) disease in SSc.

Conclusion: PPIs are frequently prescribed in SSc. Side effects are a recognized concern, especially regarding long-term therapy. There is significant variation in attitudes towards surgical intervention. Future research and practical treatment recommendation for PPIs in SSc are urgently needed.

Keywords

Proton Pump Inhibitors, Humans, Scleroderma, Systemic, Gastroesophageal Reflux, Attitude of Health Personnel, Practice Patterns, Physicians', Surveys and Questionnaires, Male, Female

Published Open-Access

yes

Recommended Citation

Bandini, Giulia; Alunno, Alessia; Oliveira Pinheiro, Filipe; et al., "A Multi-national Survey to Identify Clinicians’ Perspectives Concerning Proton Pump Inhibitors in Patients With Systemic Sclerosis" (2024). Faculty, Staff and Student Publications. 3659.
https://digitalcommons.library.tmc.edu/uthmed_docs/3659