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Proton-pump Inhibitors And Risk Of Fractures: An Update Meta-analysis

B. Zhou, Y. Huang, H. Li, W. Sun, J. Liu
Published 2015 · Medicine

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SummaryTo identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture.IntroductionMany studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies.MethodsA systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses.ResultsEighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (p < 0.001; I2 = 71.9 %). After limiting to cohort studies, there was also a moderate increase in hip fracture risk without evidence of study heterogeneity. Pooling revealed that short-term use (<1 year) and longer use (>1 year) were similarly associated with increased risk of hip fracture. Furthermore, a moderately increased risk of spine (RR = 1.58, 95 % CI 1.38–1.82) and any-site fracture (RR = 1.33, 95 % CI 1.15–1.54) was also found among PPI users.ConclusionIn this update meta-analysis of observational studies, PPI use modestly increased the risk of hip, spine, and any-site fracture, but no evidence of duration effect in subgroup analysis.
This paper references
10.1370/afm.1243
Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies
Chun-Sick Eom (2011)
10.1007/s00223-008-9188-4
Increase in Vertebral Fracture Risk in Postmenopausal Women Using Omeprazole
C. Roux (2008)
Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women
LM Moberg (2014)
10.1136/bmj.315.7109.629
Bias in meta-analysis detected by a simple, graphical test
M. Egger (1997)
10.1007/s10620-012-2185-5
Proton Pump Inhibitors Increase the Incidence of Bone Fractures in Hepatitis C Patients
Michael Mello (2012)
10.1007/s00198-010-1337-8
Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study
S. Pouwels (2010)
10.1136/bmj.b2535
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
D. Moher (2009)
Study of the association between hip fracture and acidsuppressive drug use in a UK primary care set t ing
L Cea Soriano (2014)
[Epidemiology of osteoporosis].
J. Bonjour (1997)
10.1002/SIM.1186
Quantifying heterogeneity in a meta-analysis.
J. Higgins (2002)
10.1038/ajg.2011.113
Proton Pump Inhibitors and Risk of Fracture: A Systematic Review and Meta-Analysis of Observational Studies
S. Ngamruengphong (2011)
10.1111/apt.12441
Meta‐analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding
K. K. F. Tsoi (2013)
10.1016/J.AMJMED.2005.02.007
Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial.
M. B. O'Connell (2005)
10.1016/j.annepidem.2014.01.004
Proton-pump inhibitor use and hip fractures in men: a population-based case-control study.
A. Adams (2014)
10.1007/s00198-009-0891-4
Fracture risk in patients receiving acid-suppressant medication alone and in combination with bisphosphonates
F. Vries (2009)
10.1016/J.RDC.2006.08.003
Epidemiology of osteoporosis.
Cyrus Cooper (1992)
10.1007/s00223-006-0021-7
Proton Pump Inhibitors, Histamine H2 Receptor Antagonists, and Other Antacid Medications and the Risk of Fracture
P. Vestergaard (2006)
10.1007/s00198-003-1583-0
Consequences of hip fracture on activities of daily life and residential needs
E. K. Osnes (2003)
10.1016/j.amjmed.2011.01.007
Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies.
Elaine W. Yu (2011)
10.1016/j.bone.2012.09.028
Use of proton pump inhibitors and risk of fragility hip fracture in a Mediterranean region.
C. Reyes (2013)
10.1053/j.gastro.2010.03.055
Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients.
D. Corley (2010)
Proton pump inhibitors and risk of fractures : a meta - analysis of 11 international stud
EW Yu (2011)
10.1007/s12325-011-0013-5
Review of proton pump inhibitors for the initial treatment of heartburn: Is there a dose ceiling effect?
Pamela R. Kushner (2011)
10.1136/bmj.e372
Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study
H. Khalili (2012)
10.1007/s00198-012-2112-9
The effect of proton pump inhibitors on fracture risk: report from the Canadian Multicenter Osteoporosis Study
L-A. Fraser (2012)
10.1016/0197-2456(86)90046-2
Meta-analysis in clinical trials.
R. Dersimonian (1986)
10.1002/jbmr.108
Inhibiting gastric acid production does not affect intestinal calcium absorption in young, healthy individuals: a randomized, crossover, controlled clinical trial.
M. Wright (2010)
The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses
G. Wells (2014)
10.1186/1471-230X-13-145
Possible etiology of improvements in both quality of life and overlapping gastroesophageal reflux disease by proton pump inhibitor treatment in a prospective randomized controlled trial
Hubert Moennikes (2013)
10.1016/j.maturitas.2014.05.019
Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women. The WHILA study.
L. Moberg (2014)
10.1001/JAMA.296.24.2947
Long-term proton pump inhibitor therapy and risk of hip fracture.
Yu-Xiao Yang (2006)
10.1002/phar.1410
Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting.
L. Cea Soriano (2014)
10.1517/14740338.2013.809062
Hypomagnesemia and proton-pump inhibitors
Giuseppe Famularo (2013)
10.1007/s00223-008-9170-1
Acid-Suppressive Medications and Risk of Bone Loss and Fracture in Older Adults
E. Yu (2008)
10.1001/archinternmed.2010.94
Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.
S. Gray (2010)
10.1016/j.bone.2013.08.013
Proton pump inhibitor use and fracture risk - effect modification by histamine H1 receptor blockade. Observational case-control study using National Prescription Data.
Bo Abrahamsen (2013)
10.1503/cmaj.071330
Use of proton pump inhibitors and risk of osteoporosis-related fractures
L. Targownik (2008)
10.1002/jbmr.2279
Long-term proton pump inhibitor therapy and falls and fractures in elderly women: a prospective cohort study.
Joshua R. Lewis (2014)
10.1002/pds.2026
Use of proton pump inhibitors increased the risk of hip fracture: a population-based case-control study.
H. Chiu (2010)
10.1097/MEG.0b013e328348a56a
Proton pump inhibitors therapy and risk of hip fracture: a systematic review and meta-analysis
Xiaofei Ye (2011)
10.1007/s00223-014-9855-6
The Relationship Between Proton Pump Inhibitor Adherence and Fracture Risk in the Elderly
Jian Ding (2014)
10.1592/phco.28.8.951
Proton pump inhibitor use and risk of hip fractures in patients without major risk factors.
J. Kaye (2008)



This paper is referenced by
10.1007/s00228-019-02743-9
Drug-induced osteoporosis/osteomalacia: analysis in the French and Spanish pharmacovigilance databases
Quentin Dardonville (2019)
10.3390/pharmaceutics10010036
Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update
Emily S Mohn (2018)
10.1007/s00198-016-3509-7
Proton pump inhibitors and fracture: they impair bone quality and increase fall risk?
T. Sugiyama (2016)
10.1097/SPC.0000000000000332
Nonsteroidal anti-inflammatory drugs and cancer pain
Jenny Strawson (2018)
10.1016/J.SEMERG.2017.08.007
Análisis de la utilización de inhibidores de la bomba de protones en Atención Primaria
María Jesús Hernández-Arroyo (2017)
10.1007/s00198-018-4564-z
Antihistamine use and the risk of injurious falls or fracture in elderly patients: a systematic review and meta-analysis
H. Cho (2018)
10.11005/jbm.2018.25.3.141
Proton-pump Inhibitor Use and Fracture Risk: An Updated Systematic Review and Meta-analysis
Y. Nassar (2018)
10.3390/ijms20205128
Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger–Ellison Syndrome
Lingaku Lee (2019)
10.1111/apt.14589
Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study
S. Torvinen-Kiiskinen (2018)
10.1186/s40780-016-0068-1
Influence of proton pump inhibitors and histamine H2 receptor antagonists on serum phosphorus level control by calcium carbonate in patients undergoing hemodialysis: a retrospective medical chart review
Masaomi Tatsuzawa (2016)
10.1111/apt.14462
Letter: proton pump inhibitor use and fracture risk
T. Sugiyama (2018)
10.2147/DDDT.S260565
Effects of Calcium and Annatto Tocotrienol Supplementation on Bone Loss Induced by Pantoprazole in Male Rats
K. Chin (2020)
10.2147/CIA.S190983
Comparison of three criteria for potentially inappropriate medications in Chinese older adults
Zhuo Ma (2019)
Inhibitory protonové pumpy – nové molekuly , nové poznatky
(2020)
10.15171/NPJ.2017.02
Proton-pump inhibitors and risk of renal disease
Mahrang Hedaiaty (2017)
10.1007/s00198-017-3910-x
Use of proton pump inhibitors and mortality after hip fracture in a nationwide study
W. Brozek (2017)
10.17235/reed.2016.4232/2016
Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva.
Cristóbal de la Coba Ortiz (2016)
10.1007/s11739-016-1560-1
The Italian Society of Internal Medicine choosing wisely campaign
N. Montano (2016)
10.1016/J.JAPH.2019.08.012
Successful deprescribing of unnecessary proton pump inhibitors in a primary care clinic.
Danielle R. Odenthal (2019)
10.1007/s12325-016-0345-2
Characteristics of the Novel Potassium-Competitive Acid Blocker Vonoprazan Fumarate (TAK-438)
Kazuyoshi Otake (2016)
10.1007/s40261-017-0519-y
Acid-Suppressive Therapy and Risk of Infections: Pros and Cons
L. Fisher (2017)
10.1016/j.jsps.2018.05.009
The use of proton pump inhibitors among older adults with intellectual disability: A cross sectional observational study
Hadiah Almutairi (2018)
A meta-analysis of observational studies
Thawin Srinutta (2019)
Effects of long term proton pump inhibitors use in pediatrics
Marta Tavares (2016)
10.1177/8755122518780742
Medications and Micronutrients: Identifying Clinically Relevant Interactions and Addressing Nutritional Needs
Jeffery David Prescott (2018)
10.1371/journal.pone.0235163
Association between proton pump inhibitor use and risk of fracture: A population-based case-control study
J. Kim (2020)
10.1038/ajg.2016.481
Long-Term Proton Pump Inhibitor Use Is Not Associated With Changes in Bone Strength and Structure
L. Targownik (2017)
10.1016/J.NEPHRO.2017.06.005
Inhibiteurs de la pompe à protons et rein
Geoffroy Desbuissons (2017)
10.14740/gr944w
Internists’ Perceptions of Proton Pump Inhibitor Adverse Effects and Impact on Prescribing Practices: Results of a Nationwide Survey
J. Kurlander (2018)
10.1111/bcp.13615
Safe use of proton pump inhibitors in patients with cirrhosis
R. Weersink (2018)
10.1016/j.ekir.2017.01.005
Proton Pump Inhibitors and Kidney Disease—GI Upset for the Nephrologist?
Stephanie M. Toth-Manikowski (2017)
10.2215/CJN.02190218
Proton Pump Inhibitors, Histamine-2 Receptor Antagonists, and Hip Fracture Risk among Patients on Hemodialysis.
Chandan Vangala (2018)
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