Tag Archives: Drug

What’s your reaction to the NHS ‘breakthrough’ breast cancer drug?

Two ‘breakthrough’ breast cancer drugs are to be available on the NHS after the National Institute for Health and Care Excellence (Nice) negotiated prices for the treatments.

The standard price for one cycle of palbociclib is £2,950 for a pack of 21 capsules. The list price for one cycle of ribociclib is also £2,950 but this is for 63 tablets. The company had first offered the drug at a price that was rejected by NICE, but they had later come to a “confidential agreement around the price”.

The Institute of Cancer Research (ICR), London, described the drugs as among the “most important breakthroughs” for women with advanced cancer in the last two decades.

Around 8,000 people in England with previously untreatable breast cancer will now have access to palbociclib and ribociclib which have been shown to slow the progression of advanced cancer by at least 10 months, and can delay the need for chemotherapy.

The latest draft guidance from Nice said that women with oestrogen receptor positive breast cancer that is diagnosed after it has begun to spread will be eligible for palbociclib – also known as Ibrance. If they have gone through the menopause, they will be eligible for ribociclib – also known as Kisqali.

Take part

If you’ve been affected by the story, we’d like to hear from you. We’d also like to hear from medical professionals and people who work in the pharmaceutical industry about what this means for the availability of other drugs.

You can fill in the encrypted form below – anonymously if you prefer – and we’ll use a selection of responses in our reporting.

You can also email: carmen.fishwick@theguardian.com

Rapid use of blood drug could save thousands of lives, study finds

Immediate treatment with a cheap and widely available clot-stabilising drug could save the lives of thousands of people each year, including women with severe bleeding after childbirth, a study has found.

A meta-analysis of more than 40,000 patients found that the likelihood of death due to blood loss was reduced by more than 70% if tranexamic acid was administered straight after injury or birth.

But the effectiveness of the drug – available over the counter in the UK to women suffering from heavy periods – diminished over time. The chances of survival fell by 10% for each 15-minute delay, with no benefit seen when administered after three hours.

Postpartum haemorrhage (excessive bleeding after childbirth) is the leading cause of maternal death worldwide, killing about 100,000 women a year, mostly in low- and middle-income countries. More than 2 million people worldwide die from traumatic extracranial bleeding, often as a result of road traffic injuries and violence.

Prof Ian Roberts from the London School of Hygiene and Tropical Medicine, who initiated the study, said: “Responding quickly can be the difference between life and death and that means patients must be treated urgently at the scene of injury or as soon as the diagnosis of haemorrhage is made. We have to make sure tranexamic acid is available before patients reach hospital and whenever a woman gives birth.”

Antifibrinolytic drugs work by stopping blood clots from breaking down and reducing bleeding. They have been used for many years to reduce heavy menstrual bleeding and are often given during surgery to reduce the need for blood transfusions.

For the meta-analysis, published in the Lancet on Tuesday, the authors identified a total of 13 tranexamic acid trials conducted between 1946 and 2017 – but only two assessed the impact of treatment time on its effectiveness.

Their analysis showed that almost two-thirds of bleeding deaths occurred within 12 hours of onset (884 of 1,408 bleeding deaths). Deaths due to postpartum haemorrhage peaked two to three hours after childbirth.

Survival from severe bleeding increased by a fifth with the use of tranexamic acid compared with placebo, irrespective of the site of bleeding. Only 1.5% of women given tranexamic acid died of bleeding versus 1.9% of women given placebo plus standard care, and 4.9% of trauma patients given tranexamic acid died of bleeding compared with 5.7% given placebo and standard care.

The researchers took age and systolic blood pressure into account. They found no evidence of complications or increased risk of clotting (ie heart attack, stroke, pulmonary embolism, and deep vein thrombosis) compared with placebo, and fewer cases of heart attacks were noted with tranexamic acid, which is also used as a skin whitener in Japan and the far east.

The study builds on previous research which showed that tranexamic acid cut deaths due to postpartum haemorrhage and bleeding after serious injury by about a third if given within three hours of the onset of bleeding.

Roberts said: “Tranexamic acid is safe, cheap, easily administered, and does not need to be refrigerated. Most haemorrhage deaths occur within hours of bleeding onset. Prompt treatment has the potential to save thousands of additional lives worldwide every year.

“Given the importance of early treatment, time from bleeding onset to early treatment should be audited and communicated to healthcare professionals. Establishing national or regional quality improvement initiatives, with best practice benchmarking of time to treatment, might improve survival.”

He said more research was needed to understand the mechanism of the treatment.

Drug use more likely than smoking among secondary school pupils

Secondary school children in England are now more likely to have tried drugs than cigarettes, according to a national survey. The statistics, from NHS Digital, found 24% of 11-15-year-olds saying they had tried recreational drugs at least once in their lives, a nine percentage point rise on the last survey, in 2014.

The survey also found 19% of respondents saying they had smoked cigarettes at least once, a proportion roughly level with 2014 but well below the figure for 1996 when almost half of pupils questioned had tried smoking. And, in 2016, only 6% of pupils were classified as current smokers.

Drugs use among youngsters was shown to have been declining over the past 15 years, and Paul Niblett, the statistician responsible for the report, said another survey would be needed to establish whether the figures constituted a change in trend.

Niblett said the rise could be partly explained by new questions on the survey asking youngsters about their use of laughing gas (nitrous oxide) and novel psychoactive substances, which were banned last year under sweeping new legislation.

However, even after stripping out the results from these questions, the survey of 12,000 school children carried out under exam conditions in 177 English schools in 2016, still registered a rise in the proportion admitting using drugs, to 21% – a six percentage point increase on the previous survey.

The survey also found that 44% of secondary school pupils said they had drunk alcohol at some point. There had been a steady decline in the proportion admitting to ever having had an alcoholic drink, since the early 2000s until 2014, when 38% said they had tried alcohol. However, those responsible for the survey said the new figure was not comparable to previous years due to a change in the survey question.

In 2016 the survey found consumption of alcohol related to the age of the children questioned; it ranged from 15% of the 11-year-olds having had a drink, to 73% of those aged 15. Girls were slightly more likely to have ever had a drink than boys, at 46% to 43%.

The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once.


The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once. Photograph: Ian West/PA

The headline figure of drug use also disguises differences in age. While only about one in 10 of the 11-year-olds reported ever having taken drugs, 37% of respondents aged 15 said they had.

Black pupils were the most likely to have taken drugs, followed by those of mixed ethnicity, followed by Asians, then white pupils, then others. The picture for drinking prevalence varied; white pupils were the most likely to have ever had an alcoholic drink, followed by mixed, then black, “other” and Asian.

Black girls were far more likely to have tried drugs than black boys, and mixed ethnicity girls were slightly more likely to have taken drugs than boys of that group. Among white children, Asians and others, boys were more likely to have tried drugs.

About half of the pupils questioned had acquired their drugs from a friend on the most recent occasion, with most of those being a friend of the same age. Just over a quarter said they had bought their drugs from a dealer, a proportion that increased with age.

Cannabis was the most commonly used drug, with just over 9% admitting ever having used it, followed by volatile substances (a category including glue, gas, aerosols and solvents) for which just under 9% admitted at least one use.

About 6% admitted having used nitrous oxide, some 3.5% admitted taking stimulants (mostly cocaine and ecstasy), and 2% said they had used psychedelics. Only about one in 200 had ever tried heroin.

Steve Rolles, senior policy analyst at Transform Drug Policy Foundation, which calls for drug law reform, said the findings showed the success of the public health approach to drinking and smoking, compared to the failure of the prohibitory approach towards drug use. “We are actually seeing success of effective regulation of tobacco, relative to failure of the total absence of regulation of drugs. It shows that regulation can work and it shows that public health education can work. So why do we have this wildly different approach for drugs? Effective education has actually denormalised tobacco use.”

Drug use more likely than smoking among secondary school pupils

Secondary school children in England are now more likely to have tried drugs than cigarettes, according to a national survey. The statistics, from NHS Digital, found 24% of 11-15-year-olds saying they had tried recreational drugs at least once in their lives, a nine percentage point rise on the last survey, in 2014.

The new survey also found 19% of respondents saying they had smoked cigarettes at least once, a proportion roughly level with 2014 but well below the figure for 1996 when almost half of pupils questioned had tried smoking. And, in 2016, only 6% of pupils were classified as current smokers.

Drugs use among youngsters was shown to have been declining over the past 15 years, and Paul Niblett, the statistician responsible for the report, said another survey would be needed to establish whether the figures constituted a change in trend.

Niblett said the rise could be partly explained by new questions on the survey asking youngsters about their use of laughing gas (nitrous oxide) and novel psychoactive substances, which were banned last year under sweeping new legislation.

However, even after stripping out the results from these questions, the survey of 12,000 school children carried out under exam conditions in 177 English schools in 2016, still registered a rise in the proportion admitting using drugs, to 21% – a six percentage point increase on the previous survey.

The survey also found that 44% of secondary school pupils said they had drunk alcohol at some point. There had been a steady decline in the proportion admitting to ever having had an alcoholic drink, since the early 2000s until 2014, when 38% said they had tried alcohol. However, those responsible for the survey said the new figure was not comparable to previous years due to a change in the survey question.

In 2016 the survey found consumption of alcohol related to the age of the children questioned; it ranged from 15% of the 11-year-olds having had a drink, to 73% of those aged 15. Girls were slightly more likely to have ever had a drink than boys, at 46% to 43%.

The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once.


The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once. Photograph: Ian West/PA

The headline figure of drug use also disguises differences in age. While only about one in 10 of the 11-year-olds reported ever having taken drugs, 37% of respondents aged 15 said they had.

Black pupils were the most likely to have taken drugs, followed by those of mixed ethnicity, followed by Asians, then white pupils, then others. The picture for drinking prevalence varied; white pupils were the most likely to have ever had an alcoholic drink, followed by mixed, then black, “other” and Asian.

Black girls were far more likely to have tried drugs than black boys, and mixed ethnicity girls were slightly more likely to have taken drugs than boys of that group. Among white children, Asians and others, boys were more likely to have tried drugs.

About half of the pupils questioned had acquired their drugs from a friend on the most recent occasion, with most of those being a friend of the same age. Just over a quarter said they had bought their drugs from a dealer, a proportion that increased with age.

Cannabis was the most commonly used drug, with just over 9% admitting ever having used it, followed by volatile substances (a category including glue, gas, aerosols and solvents) for which just under 9% admitted at least one use.

About 6% admitted having used nitrous oxide, some 3.5% admitted taking stimulants (mostly cocaine and ecstasy), and 2% said they had used psychedelics. Only about one in 200 had ever tried heroin.

Steve Rolles, senior policy analyst at Transform Drug Policy Foundation, which calls for drug law reform, said the findings showed the success of the public health approach to drinking and smoking, compared to the failure of the prohibitory approach towards drug use. “We are actually seeing success of effective regulation of tobacco, relative to failure of the total absence of regulation of drugs. It shows that regulation can work and it shows that public health education can work. So why do we have this wildly different approach for drugs? Effective education has actually denormalised tobacco use.”

Drug giants threaten NHS with legal action over cheaper drug that could save £84m a year

Two multinational drug companies are threatening legal action to prevent patients being offered a cheap version of an effective drug against blindness which could save the NHS millions of pounds.

Twelve NHS clinical commissioning groups (CCGs) in the north-east of England say that saving money by buying a safe and effective – but 10 times cheaper – version of the licensed drug for wet macular degeneration is far preferable to cutting costs in other ways, for instance by rationing fertility treatment or cataract operations.

The licensed drug for the condition, which is the commonest cause of blindness in older age, is Lucentis (known generically as ranibizumab). But more than a decade ago, doctors discovered that an anti-cancer drug, Avastin (bevacizumab), gives results that are just as good – and when it is split into the tiny doses needed to inject into the back of the eye, it is a fraction of the price.

Genentech, the manufacturer of Avastin, refused to apply for a licence for it to be used in eyes. But in 2012, the IVAN trial, funded by the NHS, showed that the two drugs were equally safe and effective and that its widespread use could potentially save the NHS more than £84m a year. Avastin is widely used in the United States and other countries around the world to treat macular degeneration.

It is not much used in the UK, however, and now the two drug giants that market Lucentis, Novartis and Bayer, have warned the NHS commissioners that they will seek a judicial review if they go ahead with their plans to offer Avastin.

Dr David Hambleton, chief officer of the South Tyneside Clinical Commissioning Group, one of the 12, said that offering Avastin first to patients, but with the option to choose Lucentis if they preferred, had the potential to save significant amounts of money without sacrificing safety or efficacy.

“Lots of the decisions and choices we are potentially facing are much less palatable than this one,” he told the Guardian. “This seems to most people to be an absolute no-brainer.”

Explaining the new policy in the British Medical Journal, he writes: “Every patient who chooses the cheaper alternative drug will help the NHS to fund important medical treatment in other areas. We want to have informed conversations with our patients so that they understand the wider effects of the choices we collectively make.”

Choosing Avastin could save the region up to £13.5m a year, which could pay for an extra 270 nurses or 266 heart transplants, says the BMJ.

In the UK, he said, “legal technicalities” stand in the way of more general use. Doctors are entitled to use any drug in their patients that they consider they need, but the General Medical Council, which regulates the profession, says they should choose a licensed over an unlicensed medicine if they are equally good. Avastin is not licensed for macular degeneration, but it is licensed for cancer treatment. Hambleton observes that a licence is simply a “market authorisation”, entitling a drug company to sell a product.

The National Institute for Health and Care Excellence (Nice) has produced draft guidelines for the NHS on the treatment of macular degeneration which endorse the safety and effectiveness of Avastin, but reflect the GMC’s position that it is not licensed for the condition.

NHS Clinical Commissioners, the umbrella body for the CCGs, strongly backs the use of the cheaper drug. “Where cheaper medicines that are equally clinically effective as a more expensive alternative are available, we call on the Department of Health to ensure that every possible avenue is explored to enable these savings to be realised. The time to take action on the use of this drug at a national level, to release cost-savings to use in other priority areas, is now,” it said in a statement.
In a statement, Bayer said that splitting doses of Avastin into tiny injectable amounts created a different and unlicensed medicine. “The principle of using unlicensed medicines when licensed and Nice-approved options are available runs the risk of setting a precedent that undermines the regulatory framework and NHS constitution. Bayer is currently considering its position including the possibility of legal proceedings against the CCGs who have implemented the policy,” it said.

Novartis said the new policy of the 12 CCGs “is not in line with the current UK and EU legal and regulatory framework, the purpose of which is, among others, to protect patients and monitor the safe, appropriate use of medicines. The framework provides that unlicensed medicines can only be used where there is an unmet medical need. That is not the case here as there are two licensed products available in the UK, both of which have been approved by Nice as clinically and cost effective.”

The 12 CCGs are Northumberland; Newcastle Gateshead; North Tyneside; South Tyneside; Darlington; Durham Dales, Easington and Sedgefield; North Durham; Hartlepool and Stockton-on-Tees; Cumbria; Sunderland; Hambleton, Richmondshire and Whitby; and South Tees.

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”