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Hip fracture risk increased with long-term use of certain heartburn medications
Treatment with a proton pump inhibitor for longer than 1 year increased the risk of hip fracture by 44%.
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Treating acid-related diseases, including gastroesophageal reflux disease, using certain acid suppressing medications called proton pump inhibitors may significantly increase patients' risks for suffering hip fractures, a case-control study found.
Yu-Xiao Yang, MD, MSCE, and colleagues at the University of Pennsylvania School of Medicine, Philadelphia, evaluated the effects of treatment with proton pump inhibitors (PPIs), such as Prilosec (omeprazole, Procter & Gamble Co.), has on bone metabolism and hip fracture risk in a large group of patients representative of the general population.
They published their results in the Journal of the American Medical Association.
Overall, the data analysis included 13,556 hip fracture cases and 135,386 control patients. All patients were aged 50 years and older and had been included in the United Kingdom's General Practice Research Database between 1987 and 2003.
Yang and colleagues found that treatment with a PPI for longer than 1 year significantly increased the risk of hip fracture by 44% (P<.001). In addition, patients who used high-dose PPIs for longer than 1 year had a risk of hip fracture 2.6 times higher than patients who did not use acid-suppressing medications (P<.001), according to the study.
The researchers also found a significant association between the risk of hip fracture and use of other acid-suppressing medications known as histamine 2 receptor agonists (H2RA). Patients using H2RA drugs for longer than 1 year had a 23% higher risk for hip fracture (P<.001), according to the study.
Some research has shown that PPI therapy may decrease insoluble calcium absorption or bone density in certain patients. These factors could increase the risk for hip fracture, the authors said.
"[We] observed that PPI therapy is associated with a significantly increased risk of hip fractures, with the highest risk seen among those receiving high-dose PPI therapy. Osteoporotic fractures are common among the elderly population, and they entail considerable morbidity and mortality. On the other hand, PPI therapy is widespread and may have an exaggerated effect among those at risk for osteoporosis. Thus, further studies are urgently needed to confirm our findings and clarify the underlying mechanism," the study authors said.
For more information:
- Yang Y, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296:2947-2953.