Abstract
Chan Hyuk Park, Eun Hye Kim, Yun Ho Roh, et al. PLoS One 2014. DOI: 10.1371/journal.pone.0112558
The use of proton pump inhibitors (PPIs) has been linked to hypomagnesaemia in a number of case reports. In 2012, the MHRA issued a Drug Safety Update advising measurement of magnesium before starting PPI treatment, and repeat measurements periodically during prolonged treatment, especially in those taking other drugs that may cause hypomagnesaemia. However, comparative studies published subsequently have been conflicting. This meta-analysis therefore aimed to re-examine the risk of hypomagnesaemia with PPI use.
Nine studies (115,455 patients) were included in the meta-analysis. In patients receiving PPIs, the median proportion with hypomagnesaemia was 27.1% (range 11.3–55.2%), compared to 18.4% (4.3–52.7%) in patients not receiving PPIs. A pooled odds ratio for PPI use was 1.775 (95% confidence interval 1.077–2.924) in patients with hypomagnesaemia; however, there was significant heterogeneity in the included studies (Cochran’s Q test, P < 0.001).
This meta-analysis provides support for the notion of PPI-induced hypomagnesaemia; however, a definitive conclusion cannot be drawn due to the heterogeneity of the studies included. Prospective cohort studies of PPI use, with regular magnesium monitoring, are needed to address this.