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Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study.
Osteoporos Int 2011; 22(3):903-10OI

Abstract

Previous studies evaluated the association between proton pump inhibitor (PPI) use and subsequent fracture risk, but they showed ambiguous results. Therefore, the objective was to evaluate this association in a different study population. Our findings show that there is probably no causal relationship between PPI use and hip fracture risk.

INTRODUCTION

Previous studies evaluated the association between PPI use and subsequent fracture risk, but they showed ambiguous results. To further test these conflicting results, the objective of this study was to evaluate the association between the use of PPIs and the risk of hip/femur fracture in a different study population.

METHODS

A case-control study was conducted using data from the Dutch PHARMO record linkage system. The study population included 6,763 cases aged 18 years and older with a first hip/femur fracture during enrollment and 26,341 age-, gender- and region-matched controls.

RESULTS

Current users of PPIs had an increased risk of hip/femur fracture yielding an adjusted odds ratio (AOR) of 1.20 (95% CI 1.04-1.40). Fracture risk attenuated with increasing durations of use, resulting in AORs of 1.26 (95% CI 0.94-1.68) in the first 3 months, 1.31 (95% CI 0.97-1.75) between 3 and 12 months, 1.18 (95% CI 0.92-1.52) between 13 and 36 months and 1.09 (95% CI 0.81-1.47) for use longer than 36 months.

CONCLUSION

Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. The observed association may be the result of unmeasured distortions: although current use of PPIs was associated with a 1.2-fold increased risk of hip/femur fracture, the positive association was attenuated with longer durations of continuous use. Our findings do not support that discontinuation of PPIs decreases risk of hip fracture in elderly patients.

Authors+Show Affiliations

Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Universiteit Utrecht, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20585937

Citation

Pouwels, S, et al. "Use of Proton Pump Inhibitors and Risk of Hip/femur Fracture: a Population-based Case-control Study." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 22, no. 3, 2011, pp. 903-10.
Pouwels S, Lalmohamed A, Souverein P, et al. Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study. Osteoporos Int. 2011;22(3):903-10.
Pouwels, S., Lalmohamed, A., Souverein, P., Cooper, C., Veldt, B. J., Leufkens, H. G., ... de Vries, F. (2011). Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 22(3), pp. 903-10. doi:10.1007/s00198-010-1337-8.
Pouwels S, et al. Use of Proton Pump Inhibitors and Risk of Hip/femur Fracture: a Population-based Case-control Study. Osteoporos Int. 2011;22(3):903-10. PubMed PMID: 20585937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study. AU - Pouwels,S, AU - Lalmohamed,A, AU - Souverein,P, AU - Cooper,C, AU - Veldt,B J, AU - Leufkens,H G, AU - de Boer,A, AU - van Staa,T, AU - de Vries,F, Y1 - 2010/06/29/ PY - 2010/04/24/received PY - 2010/05/31/accepted PY - 2010/6/30/entrez PY - 2010/6/30/pubmed PY - 2011/11/4/medline SP - 903 EP - 10 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 22 IS - 3 N2 - UNLABELLED: Previous studies evaluated the association between proton pump inhibitor (PPI) use and subsequent fracture risk, but they showed ambiguous results. Therefore, the objective was to evaluate this association in a different study population. Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. INTRODUCTION: Previous studies evaluated the association between PPI use and subsequent fracture risk, but they showed ambiguous results. To further test these conflicting results, the objective of this study was to evaluate the association between the use of PPIs and the risk of hip/femur fracture in a different study population. METHODS: A case-control study was conducted using data from the Dutch PHARMO record linkage system. The study population included 6,763 cases aged 18 years and older with a first hip/femur fracture during enrollment and 26,341 age-, gender- and region-matched controls. RESULTS: Current users of PPIs had an increased risk of hip/femur fracture yielding an adjusted odds ratio (AOR) of 1.20 (95% CI 1.04-1.40). Fracture risk attenuated with increasing durations of use, resulting in AORs of 1.26 (95% CI 0.94-1.68) in the first 3 months, 1.31 (95% CI 0.97-1.75) between 3 and 12 months, 1.18 (95% CI 0.92-1.52) between 13 and 36 months and 1.09 (95% CI 0.81-1.47) for use longer than 36 months. CONCLUSION: Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. The observed association may be the result of unmeasured distortions: although current use of PPIs was associated with a 1.2-fold increased risk of hip/femur fracture, the positive association was attenuated with longer durations of continuous use. Our findings do not support that discontinuation of PPIs decreases risk of hip fracture in elderly patients. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/20585937/Use_of_proton_pump_inhibitors_and_risk_of_hip/femur_fracture:_a_population_based_case_control_study_ L2 - https://dx.doi.org/10.1007/s00198-010-1337-8 DB - PRIME DP - Unbound Medicine ER -