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Fracture risk and bone mineral density reduction associated with proton pump inhibitors.
Pharmacotherapy 2012; 32(1):67-79P

Abstract

Many patients receive prolonged proton pump inhibitor (PPI) therapy for upper gastrointestinal disorders, but the long-term safety of PPIs, particularly increased risk of hip and nonhip fractures, has been questioned. To summarize the current literature on the risk of bone mineral density (BMD) reduction and fracture associated with PPI therapy, we conducted a literature search to identify all pertinent studies from 1980-February 2011. A total of 14 observational studies were included in this review. Most studies evaluated the risk of fracture associated with prolonged PPI exposure. Eight studies found an increased fracture risk at the hip, and five studies found an increased fracture risk at the spine associated with PPIs. Three studies showed reduction in fracture risk associated with PPIs after discontinuation for 1 month-1 year. Three studies evaluated the risk of BMD reduction associated with PPIs but did not find consistent changes in baseline or subsequent BMD. The current data suggest a modest increase in the risk of hip fracture and vertebral fracture associated with PPIs, although some studies showed conflicting results. Further studies will be needed to determine whether the increased risk of fracture is due to PPI exposure or residual confounding.

Authors+Show Affiliations

The Department of Pharmacy Practice, Texas A&M Health Science Center Rangel College of Pharmacy, Kingsville, Texas 78363, USA. lau@pharmacy.tamhsc.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22392829

Citation

Lau, Yuen Ting, and Nasiya N. Ahmed. "Fracture Risk and Bone Mineral Density Reduction Associated With Proton Pump Inhibitors." Pharmacotherapy, vol. 32, no. 1, 2012, pp. 67-79.
Lau YT, Ahmed NN. Fracture risk and bone mineral density reduction associated with proton pump inhibitors. Pharmacotherapy. 2012;32(1):67-79.
Lau, Y. T., & Ahmed, N. N. (2012). Fracture risk and bone mineral density reduction associated with proton pump inhibitors. Pharmacotherapy, 32(1), pp. 67-79. doi:10.1002/PHAR.1007.
Lau YT, Ahmed NN. Fracture Risk and Bone Mineral Density Reduction Associated With Proton Pump Inhibitors. Pharmacotherapy. 2012;32(1):67-79. PubMed PMID: 22392829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture risk and bone mineral density reduction associated with proton pump inhibitors. AU - Lau,Yuen Ting, AU - Ahmed,Nasiya N, PY - 2012/3/7/entrez PY - 2012/3/7/pubmed PY - 2012/10/23/medline SP - 67 EP - 79 JF - Pharmacotherapy JO - Pharmacotherapy VL - 32 IS - 1 N2 - Many patients receive prolonged proton pump inhibitor (PPI) therapy for upper gastrointestinal disorders, but the long-term safety of PPIs, particularly increased risk of hip and nonhip fractures, has been questioned. To summarize the current literature on the risk of bone mineral density (BMD) reduction and fracture associated with PPI therapy, we conducted a literature search to identify all pertinent studies from 1980-February 2011. A total of 14 observational studies were included in this review. Most studies evaluated the risk of fracture associated with prolonged PPI exposure. Eight studies found an increased fracture risk at the hip, and five studies found an increased fracture risk at the spine associated with PPIs. Three studies showed reduction in fracture risk associated with PPIs after discontinuation for 1 month-1 year. Three studies evaluated the risk of BMD reduction associated with PPIs but did not find consistent changes in baseline or subsequent BMD. The current data suggest a modest increase in the risk of hip fracture and vertebral fracture associated with PPIs, although some studies showed conflicting results. Further studies will be needed to determine whether the increased risk of fracture is due to PPI exposure or residual confounding. SN - 1875-9114 UR - https://www.unboundmedicine.com/medline/citation/22392829/Fracture_risk_and_bone_mineral_density_reduction_associated_with_proton_pump_inhibitors_ L2 - https://doi.org/10.1002/PHAR.1007 DB - PRIME DP - Unbound Medicine ER -