Fracture risk with taking PPIs

USING drugs such as proton pump inhibitors (PPIs) to suppress gastric acid secretion can impair calcium absorption. This could alter bone metabolism and increase the risk of fractures, but studies have been inconclusive. The Department of Family Medicine at the National University of Korea has therefore carried out a meta-analysis of the studies.

The reviewers found 11 relevant studies. None of these studies was a randomised controlled trial. There were five case-control studies, three nested case-control studies and three cohort studies. Six studies assessed PPIs and H2-receptor antagonists, four studied PPIs and one studied H2-receptor antagonists alone.

There was a significant association between PPIs and fractures (odds ratio 1.29). This association was seen in all three types of study, irrespective of the quality of the studies.

PPIs increased the risk of hip and vertebral fractures. There was no association with other types of fracture. Long