[Prophylaxis with proton pump inhibitors in case of corticosteroid therapy: "less is more"].

Abstract

It is common to routinely prescribe gastric ulcer prophylaxis with proton pump inhibitors (PPIs) when administering high-dose glucocorticoids (GC) (> 30 mg/day of prednisone equivalent) or during prolonged time (> 15 days). This routine is due to a risk profile considered safe for PPIs in comparison to the possible severe consequences of developing a gastric ulcer. Given the numerous adverse effects associated with PPIs, it is preferable to question the risk-benefit balance when prescribing them. The objective of this article is to summarize the evidence for gastric ulcer prophylaxis with PPI in the event of GC treatment, in an outpatient medical setting or in acute care (excluding intensive care).