Current Use of Proton Pump Inhibitors is Associated With an Increased Risk of Osteoporotic Fractures: A Meta-Analysis
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AbstractBackground: The association between the use of proton pump inhibitors (PPIs) and the risk of osteoporotic fractures has been inconsistently presented in the existing literatures. Aim: We performed a meta-analysis to evaluate the association between PPI use and the risk of osteoporotic fractures. Methods: Full publications of cohort studies and case-control studies were identified in Ovid databases from 1950 to 2010. Two reviewers independently extracted the data. The reported relative risks (RR) of osteoporotic fractures were pooled by metaanalysis. Random-effects model was used to handle heterogeneous data. Outcome measures included the incidence of (i) hip fractures, (ii) spine fractures and (iii) overall fractures, amongst current PPI users and non-PPI users. Subgroup analyses on the patients received PPI over 1 year and over 3 years were performed. Results: Four cohort studies and 7 casecontrol studies that fulfilled search criteria were identified. Among 1,534,487 subjects (mean age 59.6 years; 62.9% female) recruited in these studies, 334,259 were current PPI-users and 1,200,228 were non-PPI users. Current use of PPI was associated with an increased risk of hip fractures (RR 1.16, 95% CI 1.07-1.27), spine fractures (RR 1.07, 95% CI 1.01- 1.14), and overall fractures (RR 1.14, 95% CI 1.06-1.24) (Figure 1). The combined effects in the cohort studies (RR 1.21, 95% CI 1.12-1.32) were larger than that in case-control studies (RR: 1.10, 95% CI 0.99-1.24). In the subgroup analysis, the risks of overall fractures were increased among patients received longer duration of PPI (Current use of PPI over a year: RR: 1.15, 95% CI 1.01-1.31 and over three year: RR: 1.18, 95% CI 1.09-1.27). Conclusion: The current use of PPIs is associated with an increased risk of osteoporotic fractures. Further investigation on the causal relationship between PPI use and bone mineral density loss is required. The present data suggest that PPI therapy should be cautiously prescribed in patients with lower bone mineral density. (Table presented).
All Author(s) ListTsoi KK, Ng SC, Wong MC, Hirai HW, Lam T, Chan FKL
Name of ConferenceConference on Digestive Disease Week 2011
Start Date of Conference07/05/2011
End Date of Conference10/05/2011
Place of ConferenceChicago
Country/Region of ConferenceUnited States of America
Proceedings TitleGASTROENTEROLOGY
Year2011
Month5
Volume Number140
Issue Number5, Suppl. 1
PagesS210 - S210
ISSN0016-5085
LanguagesEnglish-United States

Last updated on 2021-29-11 at 00:39