The Article in Brief
Use of Acid Suppressive Drugs and Risk of Fracture: A Meta-Analysis of Observational Studies
Chun-Sick Eom , and colleagues
Background Acid suppression medications, including proton pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs), are among the most widely used drugs in the world. Previous research has reported inconsistent findings about an association between use of such drugs and fracture risk. This study analyzed existing research to investigate the association between the use of PPIs and H2RAs and the risk of fracture.
What This Study Found Long-term use of proton pump inhibitors, but not H2-receptor antagonists, is associated with increased risk of fracture. The meta-analysis of 11 studies finds that PPIs are associated with a 29 percent increase of fracture, including 31 percent increased risk of hip fracture and a 54 percent increased risk of vertebral fractures. Long-term H2RA use, by contrast, was not significantly associated with fracture risk.
Implications
- Given the widespread use of acid-suppressive drugs, these findings have important implications for public health.
- The authors conclude that clinicians should carefully consider their decision to prescribe PPIs for patients, especially those who already have an elevated risk of fracture because of age or other factors.