Use of proton pump inhibitors and risk of hip/femur fracture: population-based case-control study
Use of proton pump inhibitors and risk of hip/femur fracture: population-based case-control study
Summary: Previous studies evaluated the association between proton pump inhibitor (PPI) use and subsequent fracture risk, but they showed ambiguous results. Therefore, the objective was to evaluate this association in a different study population. Our findings show that there is probably no causal relationship between PPI use and hip fracture risk.
Introduction: Previous studies evaluated the association between PPI use and subsequent fracture risk, but they showed ambiguous results. To further test these conflicting results, the objective of this study was to evaluate the association between the use of PPIs and the risk of hip/femur fracture in a different study population.
Methods: A case-control study was conducted using data from the Dutch PHARMO record linkage system. The study population included 6,763 cases aged 18 years and older with a first hip/femur fracture during enrolment and 26,341 age-, gender- and region-matched controls.
Results: Current users of PPIs had an increased risk of hip/femur fracture yielding an adjusted odds ratio (AOR) of 1.20 (95% CI 1.04–1.40). Fracture risk attenuated with increasing durations of use, resulting in AORs of 1.26 (95% CI 0.94–1.68) in the first 3 months, 1.31 (95% CI 0.97–1.75) between 3 and 12 months, 1.18 (95% CI 0.92–1.52) between 13 and 36 months and 1.09 (95% CI 0.81–1.47) for use longer than 36 months.
Conclusion: Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. The observed association may be the result of unmeasured distortions: although current use of PPIs was associated with a 1.2-fold increased risk of hip/femur fracture, the positive association was attenuated with longer durations of continuous use. Our findings do not support that discontinuation of PPIs decreases risk of hip fracture in elderly patients.
fracture risk, histamine h2-receptor antagonist, proton pump inhibitor
903-910
Pouwels, S.
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Lalmohamed, A.
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Souverein, P.
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Cooper, C.
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Veldt, B.J.
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Leufkens, H.G.
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de Boer, A.
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van Staa, T.
7e263d59-ecc2-41f2-8b20-3f934d09c2c9
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
March 2011
Pouwels, S.
3d97460d-5b2e-4ec6-b46f-e82e338cf0c1
Lalmohamed, A.
b3bef1c3-1d0f-4e3d-b999-a00b16aff528
Souverein, P.
0f00e35b-57c4-47ca-99a4-0b307faa215d
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Veldt, B.J.
1f9be79d-4e37-4878-bd91-fd0699f41f3e
Leufkens, H.G.
6f387677-0ec5-408b-bdbc-7a50d49631b6
de Boer, A.
5621b588-a1e0-4827-8940-89efef278f13
van Staa, T.
7e263d59-ecc2-41f2-8b20-3f934d09c2c9
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Pouwels, S., Lalmohamed, A., Souverein, P., Cooper, C., Veldt, B.J., Leufkens, H.G., de Boer, A., van Staa, T. and de Vries, F.
(2011)
Use of proton pump inhibitors and risk of hip/femur fracture: population-based case-control study.
Osteoporosis International, 22 (3), .
(doi:10.1007/s00198-010-1337-8).
(PMID:20585937)
Abstract
Summary: Previous studies evaluated the association between proton pump inhibitor (PPI) use and subsequent fracture risk, but they showed ambiguous results. Therefore, the objective was to evaluate this association in a different study population. Our findings show that there is probably no causal relationship between PPI use and hip fracture risk.
Introduction: Previous studies evaluated the association between PPI use and subsequent fracture risk, but they showed ambiguous results. To further test these conflicting results, the objective of this study was to evaluate the association between the use of PPIs and the risk of hip/femur fracture in a different study population.
Methods: A case-control study was conducted using data from the Dutch PHARMO record linkage system. The study population included 6,763 cases aged 18 years and older with a first hip/femur fracture during enrolment and 26,341 age-, gender- and region-matched controls.
Results: Current users of PPIs had an increased risk of hip/femur fracture yielding an adjusted odds ratio (AOR) of 1.20 (95% CI 1.04–1.40). Fracture risk attenuated with increasing durations of use, resulting in AORs of 1.26 (95% CI 0.94–1.68) in the first 3 months, 1.31 (95% CI 0.97–1.75) between 3 and 12 months, 1.18 (95% CI 0.92–1.52) between 13 and 36 months and 1.09 (95% CI 0.81–1.47) for use longer than 36 months.
Conclusion: Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. The observed association may be the result of unmeasured distortions: although current use of PPIs was associated with a 1.2-fold increased risk of hip/femur fracture, the positive association was attenuated with longer durations of continuous use. Our findings do not support that discontinuation of PPIs decreases risk of hip fracture in elderly patients.
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Published date: March 2011
Keywords:
fracture risk, histamine h2-receptor antagonist, proton pump inhibitor
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Local EPrints ID: 175915
URI: http://eprints.soton.ac.uk/id/eprint/175915
ISSN: 0937-941X
PURE UUID: 97c85b98-f212-476c-a70e-21fd5c9d0869
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Date deposited: 01 Mar 2011 10:29
Last modified: 18 Mar 2024 02:45
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Author:
S. Pouwels
Author:
A. Lalmohamed
Author:
P. Souverein
Author:
B.J. Veldt
Author:
H.G. Leufkens
Author:
A. de Boer
Author:
T. van Staa
Author:
F. de Vries
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