Proton pump inhibitors and bone fractures
作者： Loren Laine
DOI: 10.1038/AJG.2009.48
关键词: Proton-pump inhibitor 、 Fracture risk 、 Hip fracture 、 Internal medicine 、 Acid inhibition 、 Confounding 、 Surgery 、 Medicine 、 Causal association
摘要: The objective of this study was to critically assess studies regarding proton pump inhibitors (PPIs) and fractures. A MEDLINE search conducted identify relevant articles. Three case-control assessed fractures PPI use. all subjects with fracture in Denmark 2000 revealed adjusted OR=1.18 (1.12-1.43) for use within the last year (hip OR=1.45,1.28-1.65); no dose-response relationship identified. hip UK patients > or =50 years found OR=1.44 (1.30-1.59) >1 PPIs; duration average daily dose were significantly associated risk: OR >1.75 times 2.65 (1.80-3.90). vertebral, wrist, Manitoba OR=0.99 (0.90-1.11) =1 continuous PPI; association became significant =7 (OR=1.92, 1.16-3.18). Consistency some positive results studies, and/or response two possibility that acid inhibition may decrease calcium absorption, histamine(2)-receptor antagonists support a causal association. low magnitude (ORs<2), lack one study, experimental evidence documenting mechanism, inability potential confounding factors limit statements causality. As medications, PPIs should be used appropriate indications not higher doses longer durations than necessary achieve desired outcomes.
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