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Proton-pump inhibitors and risk of fractures: an update meta-analysis.
Osteoporos Int. 2016 Jan; 27(1):339-47.OI

Abstract

To 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.

INTRODUCTION

Many 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.

METHODS

A 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.

RESULTS

Eighteen 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; I 2 = 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.

CONCLUSION

In 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.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

26462494

Citation

Zhou, B, et al. "Proton-pump Inhibitors and Risk of Fractures: an Update Meta-analysis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 27, no. 1, 2016, pp. 339-47.
Zhou B, Huang Y, Li H, et al. Proton-pump inhibitors and risk of fractures: an update meta-analysis. Osteoporos Int. 2016;27(1):339-47.
Zhou, B., Huang, Y., Li, H., Sun, W., & Liu, J. (2016). Proton-pump inhibitors and risk of fractures: an update meta-analysis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(1), 339-47.
Zhou B, et al. Proton-pump Inhibitors and Risk of Fractures: an Update Meta-analysis. Osteoporos Int. 2016;27(1):339-47. PubMed PMID: 26462494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proton-pump inhibitors and risk of fractures: an update meta-analysis. AU - Zhou,B, AU - Huang,Y, AU - Li,H, AU - Sun,W, AU - Liu,J, PY - 2015/09/11/received PY - 2015/10/01/accepted PY - 2015/10/15/entrez PY - 2015/10/16/pubmed PY - 2016/11/1/medline SP - 339 EP - 47 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 - 27 IS - 1 N2 - UNLABELLED: To 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. INTRODUCTION: Many 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. METHODS: A 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. RESULTS: Eighteen 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; I 2 = 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. CONCLUSION: In 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. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26462494/Proton_pump_inhibitors_and_risk_of_fractures:_an_update_meta_analysis_ L2 - https://dx.doi.org/10.1007/s00198-015-3365-x DB - PRIME DP - Unbound Medicine ER -