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All Journal Jurnal Ilmiah Medicamento Indonesian Journal of Global Health Research
Nabila Risti Rachmadi
Universitas Gadjah Mada
Health Professions Medicine & Pharmacology Public Health

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Ketidaksesuaian Penggunaan Proton Pump Inhibitors (PPIs) pada Lanjut Usia dan Interaksi Obat: Kajian Naratif Thendi Abdul Arief; Nabila Risti Rachmadi; Hanum Hasifah Fahriah; Agung Endro Nugroho
Jurnal Ilmiah Medicamento Vol 12 No 1 (2026): Jurnal Ilmiah Medicamento (In progress)
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v12i1.11519

Abstract

Background: PPIs are highly effective for treating gastrointestinal disorders, including dyspepsia, peptic ulcer disease, gastritis, and gastroesophageal reflux disease (GERD). Furthermore, for the prophylaxis of NSAIDs and to mitigate gastrointestinal bleeding in patients receiving glucocorticoids, antiplatelet agents, or anticoagulants, particularly in the elderly population. The prescribing of PPIs among elderly patients remains a widespread issue that can lead to inappropriate use, hospital admission, or discharge. Additionally, the inappropriate use of PPIs can lead to possible drug-drug interactions.Objective: This narrative review aims to comprehensively assess inappropriateness associated with PPIs use in the elderly population and drug-drug interactions.Methods: Studies published from 2014 to 2024 were identified through a comprehensive search of multiple databases, including PubMed, Google Scholar, and ScienceDirect.Results: Long-term dangers such as infections and nutritional deficits are increased by inappropriate usage, which is defined by unwarranted commencement and lengthy duration. Simultaneously, PPIs present significant DDI hazards through modulating the absorption of pH-dependent medications and blocking cytochrome P450 enzymes, particularly CYP2C19. These risks are made worse by the prevalence of polypharmacy and aging-related deterioration of renal and hepatic function.Conclusion: In clinical practice, these findings call for systematic drug reviews and organized deprescribing programs to detect and manage high-risk combos. Implementing PPI stewardship programs in hospital and community settings is highly advised at the policy and systems level to enhance pharmaceutical safety in this susceptible population and to encourage evidence-based, guideline-concordant prescription.
Functional and Inflammatory Outcomes of Methotrexate in Rheumatoid Arthritis: A Systematic Review Nabila Risti Rachmadi; Muhammad Ridho Akbar Eljatin; Lathifa Nabila; Alif Al-Mathari
Indonesian Journal of Global Health Research Vol. 8 No. 5 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i5.2128

Abstract

Rheumatoid arthritis is a chronic autoimmune disease characterised by persistent inflammation and functional impairment. Methotrexate remains the cornerstone therapy; however, its effects on physical function have not been consistently evaluated. To evaluate the effectiveness of methotrexate-based therapy on inflammatory control and physical function in patients with rheumatoid arthritis. This systematic review followed PRISMA guidelines. Literature searches were conducted in PubMed, Scopus, the Cochrane Library, SpringerLink, and ScienceDirect for studies published between 2016 and 2025. Eligible studies were randomised controlled trials involving adult patients with rheumatoid arthritis receiving methotrexate as monotherapy or combination therapy. The primary outcome was physical function assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI), while secondary outcomes included disease activity measures. Eight randomised controlled trials were included. Methotrexate-based therapy consistently reduced disease activity across studies, with combination regimens generally demonstrating greater inflammatory suppression than monotherapy. Improvements in physical function were observed in several studies, particularly in combination therapy groups; however, these improvements were not consistently proportional to reductions in inflammatory activity. Functional outcomes were also reported heterogeneously across studies. Methotrexate-based therapy is effective in controlling inflammatory activity in rheumatoid arthritis but does not consistently translate into proportional improvements in physical function. Persistent impairment may also be influenced by structural joint damage, chronic pain, fatigue, and psychosocial factors.  
Co-Authors Agung Endro Nugroho Alif Al-Mathari Hanum Hasifah Fahriah Lathifa Nabila Muhammad Ridho Akbar Eljatin Thendi Abdul Arief