PPIs may blunt fracture protection: study

PROTON pump inhibitors (PPIs) may reduce fracture protection from oral bisphosphonates in the elderly, researchers warn after an observational study.

In a study of concurrent PPI use with alendronate, they found a dose-dependent loss of protection against hip fracture, but not  spine, humerus or forearm fracture.

The study involved 38,000 new alendronate users in Denmark, of whom 10,000 were concurrently taking PPIs.

After a mean 3.5 years’ follow-up, people complying well with alendronate who were not using PPIs had 39% reduced risk of hip fracture, whereas the risk reduction in users of acid suppression therapy was not significant (19%).

The outcomes suggested a “pronounced blunting of the anti-fracture efficacy of alendronate, with loss of half the effect against hip fracture in patients who take PPIs,” the authors wrote.

More research was needed to verify the drug interaction and explain the mechanisms