Proton-Pump Inhibitor Use Is Not Associated With Osteoporosis or Accelerated Bone Mineral Density Loss

Targownik, Laura E.; Lix, Lisa M.; Leung, Stella; Leslie, William D.

doi:10.1053/j.gastro.2009.11.014

Cited by 228 publications

(181 citation statements)

References 39 publications

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“…[7] confirmed an increased fracture risk after the use of PPIs . In contrast, only one [13] of five prospective studies [11][12][13][14][15] found a significant negative association between PPI use and BMD at the hip, but not at other sites.…”

Section: Discussionmentioning

confidence: 84%

“…Except for the prospective cross-sectional study by Targownik et al [11], the studies investigating PPI use and BMD were prospective cohort studies (Canadian Multicentre Osteoporosis Study (CaMos) [12], Women's Health Initiative (WHI) Observational Study and Clinical Trials [13], Osteoporotic Fractures in Men Study (MrOS) and Study of Osteoporotic Fractures (SOF) [14], and Study of Women's Health Across the Nation (SWAN) [15]). …”

Section: Discussionmentioning

confidence: 99%

“…If a causal relationship exists between PPIs and fractures, the predisposing factors for fractures are expected to be affected. However, studies examining associations between PPI use and bone mineral density (BMD) found none or little evidence for an association between PPI use and the development of osteoporosis [11][12][13][14][15]. In contrast, a study by Maggio et al [16] found that PPI use was significantly associated with decreased trabecular BMD, possibly an early marker of osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

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The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

Hoorn

Tett

Vries

et al. 2015

Bone

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Please cite this article as: van der Hoorn Mariëlle M.C., Tett Susan E., de Vries Oscar J., Dobson Annette J., Peeters G.M.E.E. (Geeske), The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: a prospective cohort study, Bone (2015Bone ( ), doi: 10.1016Bone ( /j.bone.2015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT 2 ABSTRACT Objectives:Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. Methods:Data were included from 4432 participants (born 1921-26) Conclusion:An appropriate benefit/risk assessment should be made when prescribing PPIs, especially for esomeprazole and rabeprazole, as osteoporosis and fracture risks were increased in this cohort of elderly females subsequent to PPI prescription. Highlights Proton pump inhibitor (PPI) use in elderly (>77 years) women was associated with increased risk of decreased bone health. Increased risk of subsequent osteoporosis medication was associated with the most commonly prescribed PPI, esomeprazole, and with rabeprazole and use of multiple different PPIs.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

Hoorn

Tett

Vries

et al. 2015

Bone

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“…Furthermore, the cross-sectional analysis of the Manitoba BMD database aimed to determine if long-term PPI use was associated with osteoporosis and accelerated BMD declines. This study found that PPI use was not associated with osteoporosis at baseline, determined by BMD measurements at the total hip or lumbar spine (OR 0.84; 95 % CI 0.55-1.34 and OR 0.79; 95 % CI 0.59-1.06, respectively) [18]. In addition, longitudinal DXA measurements revealed no significant decrease in BMD seen in the long-term PPI users compared to the non-users [18].…”

Section: Effect Of Ppis On Bone Mineral Densitymentioning

confidence: 87%

The relationship between long-term proton pump inhibitor therapy and skeletal frailty

et al. 2015

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Proton pump inhibitors (PPIs) are a commonly prescribed class of medications. Their use has been associated with an increased rate of fractures, most notably hip fractures. However, there does not seem to be a clear association between PPI use and bone mineral density measurements, assessed by dual X-ray absorptiometry. The mechanism by which PPI use increases the risk of fractures remains unclear. This review will summarize the current evidence on this topic.

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“…Bone fractures have also been linked in several observational studies (27). A crossover study analyzed bone mineral density of the hip and lumbar vertebrae, and it showed no association between PPI use and osteoporosis (28).…”

Section: Overuse and Its Consequencesmentioning

confidence: 99%

Practical considerations in the management of proton-pump inhibitors

Aguilera¹,

Martín-de-Argila-dePrados²,

Albillos-Martínez³

2015

Rev Esp Enferm Dig

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Proton-pump inhibitors (PPIs) are one of the most active ingredients prescribed in Spain. In recent decades there has been an overuse of these drugs in both outpatient clinics and hospitals that has lead to a significant increase in healthcare spending and to an increase in the risk of possible side effects. It is important for health professionals to know the accepted indications and the correct doses for the use of these drugs. On the market there are different types of PPI: omeprazole, pantoprazole, lansoprazole, rabeprazole and esomeprazole. Omeprazole is the oldest and most used PPI, being also the cheapest. Although there are no important differences between PPIs in curing diseases, esomeprazole, a newgeneration PPI, has proved to be more effective in eradicating H. pylori and in healing severe esophagitis compared to other PPIs. In recent years the use of generic drugs has spread; these drugs have the same bioavailability than the original drugs. In the case of PPIs, the few comparative studies available in the literature between original and generic drugs have shown no significant differences in clinical efficacy.Key words: Proton-pump inhibitor. PPI. Omeprazole. Pantoprazole. Lansoprazole. Rabeprazole. Esomeprazole. INTRODUCTIONProton-pump inhibitors (PPIs) represent a family of drugs widely used in our country. The advent in the nineties of PPIs was a great revolution in the treatment of ulcer disease and gastroesophageal reflux. The main problems of PPIs at present time are its overuse and the errors in the therapeutic indication. This fact leads to a considerable health economic cost and the risk of long-term side effects. In this review the main problems of PPIs prescription, their indications, the differences between PPIs and tips on their use are discussed. Brief historical memory: since alkaline diets until PPIsThe treatment of ulcer disease and gastroesophageal reflux disease (GERD) in the early twentieth century was the prescription of alkaline foods like milk, eggs and puree (1). Later, there were products as sodium bicarbonate that improved symptoms but did not prevent complications. Surgical treatment consisted of different types of gastric surgeries for peptic ulcer disease and Nissen fundoplication for GERD (2).In the mid twentieth century the use of muscarinic antagonists was introduced, atropine being its main active ingredient. Acids secretion was partially inhibited by blocking the muscarinic receptor of the parietal cell. However, these drugs had little effectiveness and numerous adverse effects due to the amount of muscarinic receptors distributed throughout the body. E-type prostaglandin was discovered later, but, again, the limitations of these substances were their short half life and side effects. An important progress in gastric antisecretory therapy was the appearance of H 2 receptors antagonists (H 2 blockers) (3). The most used were ranitidine and famotidine. These drugs established a substantial change by blocking the action of histamine receptor in gastric parietal ...

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Proton-Pump Inhibitor Use Is Not Associated With Osteoporosis or Accelerated Bone Mineral Density Loss

Cited by 228 publications

References 39 publications

The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

The relationship between long-term proton pump inhibitor therapy and skeletal frailty

Practical considerations in the management of proton-pump inhibitors

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