Gastric Cancer Risk from Nexium, Similar Heartburn Drugs May Be Explained By New Study

Amid mounting evidence that side effects of Nexium, Prilosec, Prevacid and other similar heartburn drugs may increase the risk of gastric cancer, new research indicates that the medications appear to affect the abundance of some types of gut microbiota, which may result in the development of cancer in the stomach.

The drugs are all part of the same class of medications, known as proton pump inhibitors (PPI), which are used by millions of Americans to reduce heartburn and acid reflux. However, concerns have emerged in recent years about the gastric cancer risk from Nexium, Prilosec and other similar drugs, following the publication of studies that found users of the drugs have a much greater incidence rate, which appears to increase the longer the medications are taken.

In new findings published this month in the European Review for Medical and Pharmacological Sciences (PDF), Chinese researchers evaluated the factors that may influence the development of cancer in the stomach and the impact of proton pump inhibitors.

Researchers indicate that reducing the level of gastric acid, which is what drugs like Nexium, Prilosec, and Prevacid do, increases the risk of gastric cancer. However, there needs to be more research on the specific mechanisms linking the reduced level of gastric acid to the increased risks.

“Lowered gastric acid is a risk factor for gastric cancer. Patients with a family history of gastric cancer have a reduced acid output and increased incidence of precancerious lesions,” the researchers wrote. “Reduction of gastric acid may enhance bacteria overgrowth in the stomach, thus promoting the development of gastric cancer.”

The findings specifically note that proton pump inhibitors increase gastric pH, and that the heartburn drugs can alter the relative abundance of some bacteria in gastric microbiota. How that affects gastric cancer risks is currently unclear. The issue is made more complex by the variation in gastric microbiota due to genetics and other factors, the researchers warned.

The findings come about a year after a study by Hong Kong researchers found that drugs like Nexium and Prilosec more than doubled the risk of gastric cancer, while other types of heartburn drugs did not.

An association was previously suspected, particularly among individuals with Helicobacter pylori (HP) infections. However, the study found that the increased risk was there even after patients received HP infection treatment.

Nexium is one of the most widely used brand-name medications in the United States, which is now widely available over-the-counter. While most individuals assume that the drugs are safe, concerns about a number of serious side effects have emerged in recent years, leading to Nexium lawsuits, Prilosec lawsuits, Prevacid lawsuits and similar claims against the drug makers for failing to provide adequate warnings.

More than 4,500 claims are currently centralized in the federal court system before  U.S. District Judge Claire C. Cecchi in New Jersey, for coordinating the discovery and pretrial proceedings.

As part of the coordinated MDL proceedings, Judge Cecchi has established a “bellwether” program where a group of representative cases filed over kidney side effects will be prepared for early trial dates, which are expected to begin in late 2020. It is expected that the Court will eventually establish a separate bellwether track for gastric cancer lawsuits filed by former users of the heartburn drugs.