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Proton Pump Inhibitors Associated with Increased Hip Fracture Risk
Written by Jeanne Bohm, Ph.D.   
Use of the proton pump inhibitors (PPIs) for the treatment of gastro esophageal reflux disease (GERD) is associated with a greater risk of hip fracture, according to a study in the December 27 issue of JAMA.

Millions of patients use PPIs on a continuous or long-term basis. Research has shown that PPI therapy may decrease insoluble calcium absorption or bone density. These factors could increase the risk for hip fracture, which has a death rate during the first year after the fracture of 20 percent.

Yu-Xiao Yang, M.D., M.S.C.E., of the University of Pennsylvania School of Medicine, conducted a study to determine what effects PPI therapy has on bone metabolism and hip fracture risk. The researchers analyzed data from the General Practice Research Database (1987-2003) containing information on patients in the United Kingdom using PPI therapy as well as and nonusers of acid suppression drugs older than 50 years. There were 13,556 hip fracture cases and 135,386 controls.

The researchers found among patients taking PPI for more than 1 year had a 44 percent increased risk of hip fracture. The risk was 2.6 times higher among long-term users of high-dose PPI therapy and increased with dosage and duration of PPI therapy.

The authors concluded that PPI therapy is associated with a significantly increased risk of hip fractures, with the highest risk in patients receiving high-dose PPI therapy.

Implications of the study include physicians being aware of the potential association when prescribing PPI therapy and prescribe the lowest effective dose. Elderly patients who require long-term PPI therapy should be encouraged to increase calcium intake from a dairy source and co-ingestion of a meal when taking insoluble calcium supplements.


JAMA Media Release

Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture. JAMA. 2006;296:2947-2953.


About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.

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