Proton pump inhibitors may increase the risk of a hip fracture

Reported by Susan Aldridge, PhD, medical journalist

Use of proton pump inhibitors for acid reflux increases the risk of hip fracture, according to a new study.
Acid reflux disease - where stomach acid enters the esophagus - can be effectively treated with drugs called proton pump inhibitors (PPIs). However, some research has suggested that PPIs can decrease bone density, which may lead to an increase in the risk of hip fracture.

Researchers at the University of Pennsylvania now report on a study of the link between PPI use and hip fracture. They used the UK's General Practice Research Database, identifying both PPI users and PPI non-users and those who had, and had not, had hip fractures. The data revealed that more than one year of PPI therapy is linked to a 44 per cent bigger risk of hip fracture. The risk was 2.6 times higher among long-term users of high dose PPI therapy. In fact the strength of the association increased with both dose and duration of use of PPIs. Further studies are needed to work out how PPIs affect the bones. In the meantime, doctors should be aware of the risk of hip fracture with PPIs and prescribe the lowest possible dose. For elderly patients needing long term and high dose PPI therapy, increased calcium intake may be needed, to protect the bones.

Source
Journal of the American Medical Association 27th December 2006 Volume 196 pages 2947-2953

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