title: Proton-pump inhibitor use and hip fractures in men: a population-based case-control study.
abstract: OBJECTIVE
  To estimate the association between proton-pump inhibitor (PPI) use and hip fracture.
  
  
  METHODS
  We conducted a case-control study of 6774 pairs of men aged 45 years or older, matched on age, race, and medical center. Cases sustained incident hip fractures in 1997-2006. Fracture date was index date for each case-control pair. PPI exposure was identified from electronic pharmacy records, 1991-2006. PPI use was measured as (1) ever versus never; (2) adherence; (3) duration; and (4) recentness. Omeprazole and pantoprazole were analyzed separately using conditional logistic regression, adjusted for comorbidities. Nonusers were the referent group.
  
  
  RESULTS
  Eight hundred ninety-six (13.2%) cases and 713 (10.5%) controls used omeprazole before index date (matched odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27). Greatest adherence (medication possession ratio > 80%) (OR, 1.33; 95% CI, 1.09-1.62), highest tertile of duration (OR, 1.23; 95% CI, 1.02-1.48), and recent use (OR, 1.22; 95% CI, 1.02-1.47) were associated with hip fracture. Six hundred ninety-four (10.2%) cases and 576 (8.5%) controls had used pantoprazole (OR, 1.10; 95% CI, 0.97-1.24). Longest duration (OR, 1.25; 95% CI, 1.02-1.53) and most recent use (OR, 1.38; 95% CI, 1.12-1.71) were associated with hip fracture. Our study suggests that PPI use and hip fractures are associated, with risk increasing with longer duration and more recent use.
authors: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena. Electronic address: Annette.L.Adams@kp.org.
authors: Annette L
authors: AL
authors: Adams
authors: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors: Mary Helen
authors: MH
authors: Black
authors: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors: Jian L
authors: JL
authors: Zhang
authors: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors: Jiaxiao M
authors: JM
authors: Shi
authors: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors: Steven J
authors: SJ
authors: Jacobsen
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D016001:Confidence Intervals; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009853:Omeprazole / Q000009:adverse effects* / Q000627:therapeutic use; D010024:Osteoporosis / Q000139:chemically induced; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole; D009853:Omeprazole
keywords: Epidemiology; Hip fractures; PPI; Pharmacoepidemiology; Proton pump inhibitor