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Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting.
Pharmacotherapy 2014; 34(6):570-81P

Abstract

OBJECTIVES

We aimed to clarify the nature of the association between hip fracture risk and use of proton pump inhibitors (PPIs) or histamine2 -receptor antagonists (H2 RAs).

METHODS

We identified patients 40-89 years of age with a recorded hip fracture diagnosis in 2000-2008 using The Health Improvement Network, a UK primary care research database. Computerized records were reviewed and questionnaires sent to primary care physicians to validate hip fracture cases. A cohort study with a nested case-control analysis was performed to estimate the association between the use of acid-suppressive drugs and hip fracture.

RESULTS

Overall incidence of hip fracture per 1000 person-years was 1.31 (95% confidence interval [CI] 1.28-1.33). There was a modest increased risk of hip fracture after adjustment for potential confounders (odds ratios [OR] during current use of PPIs and H2 RAs: 1.09 [95% CI 1.01-1.17] and 1.04 [95% CI 0.90-1.19], respectively). Relative to nonuse, an increased risk of fracture was observed with medium and high doses of PPIs (OR 1.11 [95% CI 1.01-1.22] and OR 1.31 [95% CI 1.06-1.61], respectively) and high doses of H2 RAs (OR 2.77, 95% CI 1.21-6.37). No duration response was observed (ORs for current PPI use less than 1 month and 5 years or longer: 1.16 [95% CI 0.94-1.43] and 1.02 [95% CI 0.87-1.20], respectively).

CONCLUSIONS

Patients treated with PPIs showed a modest increased risk of hip fracture after adjustment for potential cofounders. Any remaining association between PPI use and hip fracture risk may be attributable to residual confounding.

Authors+Show Affiliations

Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain.No 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

24634193

Citation

Cea Soriano, Lucia, et al. "Study of the Association Between Hip Fracture and Acid-suppressive Drug Use in a UK Primary Care Setting." Pharmacotherapy, vol. 34, no. 6, 2014, pp. 570-81.
Cea Soriano L, Ruigómez A, Johansson S, et al. Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting. Pharmacotherapy. 2014;34(6):570-81.
Cea Soriano, L., Ruigómez, A., Johansson, S., & García Rodríguez, L. A. (2014). Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting. Pharmacotherapy, 34(6), pp. 570-81. doi:10.1002/phar.1410.
Cea Soriano L, et al. Study of the Association Between Hip Fracture and Acid-suppressive Drug Use in a UK Primary Care Setting. Pharmacotherapy. 2014;34(6):570-81. PubMed PMID: 24634193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting. AU - Cea Soriano,Lucia, AU - Ruigómez,Ana, AU - Johansson,Saga, AU - García Rodríguez,Luis A, Y1 - 2014/03/13/ PY - 2014/3/18/entrez PY - 2014/3/19/pubmed PY - 2015/2/11/medline KW - H2RA KW - acid-suppressive drugs KW - fractures KW - proton pump inhibitor SP - 570 EP - 81 JF - Pharmacotherapy JO - Pharmacotherapy VL - 34 IS - 6 N2 - OBJECTIVES: We aimed to clarify the nature of the association between hip fracture risk and use of proton pump inhibitors (PPIs) or histamine2 -receptor antagonists (H2 RAs). METHODS: We identified patients 40-89 years of age with a recorded hip fracture diagnosis in 2000-2008 using The Health Improvement Network, a UK primary care research database. Computerized records were reviewed and questionnaires sent to primary care physicians to validate hip fracture cases. A cohort study with a nested case-control analysis was performed to estimate the association between the use of acid-suppressive drugs and hip fracture. RESULTS: Overall incidence of hip fracture per 1000 person-years was 1.31 (95% confidence interval [CI] 1.28-1.33). There was a modest increased risk of hip fracture after adjustment for potential confounders (odds ratios [OR] during current use of PPIs and H2 RAs: 1.09 [95% CI 1.01-1.17] and 1.04 [95% CI 0.90-1.19], respectively). Relative to nonuse, an increased risk of fracture was observed with medium and high doses of PPIs (OR 1.11 [95% CI 1.01-1.22] and OR 1.31 [95% CI 1.06-1.61], respectively) and high doses of H2 RAs (OR 2.77, 95% CI 1.21-6.37). No duration response was observed (ORs for current PPI use less than 1 month and 5 years or longer: 1.16 [95% CI 0.94-1.43] and 1.02 [95% CI 0.87-1.20], respectively). CONCLUSIONS: Patients treated with PPIs showed a modest increased risk of hip fracture after adjustment for potential cofounders. Any remaining association between PPI use and hip fracture risk may be attributable to residual confounding. SN - 1875-9114 UR - https://www.unboundmedicine.com/medline/citation/24634193/Study_of_the_association_between_hip_fracture_and_acid_suppressive_drug_use_in_a_UK_primary_care_setting_ L2 - https://doi.org/10.1002/phar.1410 DB - PRIME DP - Unbound Medicine ER -