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Drug Safety
Published in: Drug Safety 10/2010

01-10-2010 | Review Article

Proton Pump Inhibitors and Fracture Risk

True Effect or Residual Confounding?

Authors: Michael Bodmer, Professor Dr Christian Meier, Marius E. Kraenzlin, Christoph R. Meier

Published in: Drug Safety | Issue 10/2010

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Abstract

Fracture is a major contributor to human morbidity and mortality, especially in the elderly. It has been discussed in the literature that conditions associated with decreased stomach acidity may lead to a decrease in intestinal calcium absorption and, consequently, to an increased fracture risk. In recent years, several observational studies reported a slightly increased fracture risk in association with the use of proton pump inhibitors (PPIs) and/or histamine H2 receptor antagonists. It was the objective of this review to critically assess the available evidence linking PPI use to an increased fracture risk. A MEDLINE and EMBASE search from 1960 to June 2010 was performed to identify the relevant articles using predefined search terms. Because (i) there is no proven mechanism, (ii) the reported magnitude of the risk elevation associated with the use of PPIs was only weak, and (iii) the likelihood of residual confounding despite adjustment for known co-morbidities and drug use cannot be ruled out, we conclude that the currently available literature does not support the notion that the use of PPIs is causally related to a materially increased fracture risk in humans.
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Metadata
Title
Proton Pump Inhibitors and Fracture Risk
True Effect or Residual Confounding?
Authors
Michael Bodmer
Professor Dr Christian Meier
Marius E. Kraenzlin
Christoph R. Meier
Publication date
01-10-2010
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 10/2010
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/11536780-000000000-00000

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