Proton pump inhibitor (PPI) use may attenuate the effect of abiraterone acetate plus prednisone (AAP) in metastatic prostate cancer

[Graham49]

Proton pump inhibitors (PPIs) are a class of medications that reduce stomach acid production. They are often used to treat heartburn, indigestion, and acid reflux.

This study aimed to examine whether concomitant PPI use is associated with survival in patients with metastatic prostate cancer treated with androgen deprivation therapy (ADT) and AAP.

“Post-hoc analysis was conducted in patients with metastatic castration-sensitive prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer (mCRPC) treated in the LATITUDE, COU-AA-301, and COU-AA-302 trials (ADT vs. ADT plus AAP).”

The study indicated: “PPI use may be associated with inferior survival in patients with metastatic prostate cancer who receive ADT plus AAP. Discontinuing unnecessary PPI use might improve those outcomes.”

Association between concomitant proton pump inhibitor use and survival of patients with metastatic prostate cancer receiving abiraterone acetate: a post-hoc analysis of pooled data from three randomized controlled trials

Wataru Fukuokaya, Keiichiro Mori, Takafumi Yanagisawa, Kohei Akazawa, Tatsuya Shimomura & Takahiro Kimura

Prostate Cancer and Prostatic Diseases volume 27, pages 444–450 (2024)

DOI

doi.org/10.1038/s41391-023-...

[cesanon]

Ppi are generally dangerous. You adapt to them. Once you start using them you must be weaned off of them.

You shouldn't be on them unless you have no viable alternatives. And that is pretty much never the case.

[Graham49 in reply to cesanon]

How about this study? Only invitro and animal study of course.

Sec. Molecular and Cellular Oncology

Volume 11 - 2021 | doi.org/10.3389/fonc.2021.6...

Drug Repurposing of Pantoprazole and Vitamin C Targeting Tumor Microenvironment Conditions Improves Anticancer Effect in Metastatic Castration-Resistant Prostate Cancer

[j-o-h-n in reply to Graham49]

The study indicated: “PPI use may be associated with inferior survival in patients with metastatic prostate cancer who receive ADT plus AAP. Discontinuing unnecessary PPI use might improve those outcomes.”

Well, well a definite maybe.

Good Luck, Good Health and Good Humor.

j-o-h-n

[fast_eddie in reply to cesanon]

I've got a hiatal hernia you could drive a truck through. I am on omeprazole or some other stomach acid reducer forever unless there is some surgery to fix that hernia. I reject your 'almost never the case' assertion as unfounded. Speak for yourself, not for the rest of us.

[Graham49 in reply to fast_eddie]

I asked Perplexed AI what the healthiest PPIs were? This is the answer:

The healthiest proton pump inhibitor (PPI) depends on individual needs, but here are key considerations:

1. Safety and Tolerability:

• Dexlansoprazole (Dexilant) is noted for fewer abdominal side effects and can be taken with or without food, making it a good option for those sensitive to side effects.

• All PPIs are generally well-tolerated, with minimal adverse effects reported in studies.

2. Effectiveness:

• Pantoprazole (Protonix) and Rabeprazole (AcipHex) have shown superior effectiveness in healing esophagitis and reducing symptoms like heartburn compared to older PPIs like omeprazole.

3. Cost and Accessibility:

• Generic options like Pantoprazole 20 mg are cost-effective and widely available, making them a practical choice for long-term use.

4. Long-Term Risks:

• All PPIs carry potential risks with long-term use, such as nutrient deficiencies (e.g., B12, magnesium) and increased infection risks. Regular monitoring by a doctor is essential.

Consult your doctor to determine which PPI aligns best with your health needs.

[fast_eddie in reply to Graham49]

Thanks for this info. I will check it out.

[vintage42]

I wonder why the study chose Abiraterone out of all the other receptor inhibitors. Maybe it was looking to confirm the problem which had been anecdotally reported. .

[gsun in reply to vintage42]

I would think because it’s the most prescribed one.

[GardenReno]

I was on omeprazole before my advanced stage 4 diagnosis. I had a cancer dietitian consult and changed diet and did a gut micro biome reset. Stopped the PPI and have had no gut issues since which is 3.5 years ago.

[Yzinger in reply to GardenReno]

What did you stop eating to cease reflux? Curious if you feel you had a trigger food or foods

Thanks