Proton pump inhibitors, osteoporosis, and osteoporosis-related fractures.
Proton pump inhibitors (PPIs) are among the most commonly prescribed medications today with an excellent short-term safety profile. Recently, a number of studies from a variety of data sources have reported an association between PPI use and hip fractures. However, there is not yet any direct evidence of a causal link between PPI use and the development of hip fracture. In the following paper, we will review the recent studies which have described this association between PPI use and hip fracture, and discuss the evidence supporting the likelihood of this association being causal, using data from previous work on the effects of surgical and pharmacological inhibition of gastric acid secretion on calcium absorption and bone mineral density. We will conclude by summarizing the current state of evidence on the relationship between gastric acid inhibition and the risk of fracture, and suggest management strategies for patients who require the long-term use of gastric acid inhibiting medications who also may be at risk for metabolic bone disease and fracture.
Fournier
Marc R
MR
Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. mrf810@mail.usask.ca
Targownik
Laura E
LE
Leslie
William D
WD
D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000493:pharmacokinetics*; D002128:Calcium Metabolism Disorders / Q000139:chemically induced*; D005744:Gastric Acid / Q000378:metabolism*; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D007408:Intestinal Absorption; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012307:Risk Factors
D054328:Proton Pump Inhibitors; D002118:Calcium