Study Confirms Hip Fracture Risk with Proton Pump Inhibitors

Another study has confirmed a risk of bone fractures associated with popular heart burn pills like <"">Nexium and Prilosec. According to a report in Internal Medicine News, the study found that regular use of the drugs – called proton pump inhibitors – to be associated with an increased risk of hip fractures, even when other factors that make broken bones more likely were taken into account.

Proton pump inhibitors include the prescription drugs Nexium, Prilosec, Zegerid, Prevacid, Protonix, and Aciphex. Last year, the U.S. Food & Drug Administration (FDA) said it would be adding information about the potential fracture risk to the label of prescription proton pump inhibitors after a review of several epidemiological studies reported an increased risk of fractures of the hip, wrist, and spine with proton pump inhibitor use. According to the FDA, the risk was most acute in women over 50 who had taken the drugs for a long period of time.

This new study consisted of a prospective evaluation from the Nurses’ Health Study, Internal Medicine News said. Nearly 80,000 post-menopausal women who participated in that study were asked in 1982 to report all previous fractures and were asked every two years about new fractures. According to the study authors, there were 893 incident hip fractures over 8 years. Proton pump inhibitor use was reported by 7% of participants in 2000 and by 19% of participants in 2008. Regular use of drugs posed fracture risks of 35%-45% when adjusted for age, calcium intake, and body mass index.

Compared to those who never used proton pump inhibitors, women who took the drugs regularly over a long period of time faced a higher risk of fractures. The risk rose to 36% after 2 years of use, 42% after 4 years and 54% when proton pump inhibitors were used for 6 years or longer.

Discontinuing use of the drugs reduced fracture risk. Two or more years after discontinuation, the risk of hip fracture was just 9%-10%.

According to Internal Medicine News, the study also accounted for other fracture risk factures, including vitamin D intake; history of osteoporosis; and use of hormone replacement therapy, bisphosphonates, and thiazides. None of these “materially altered” the risk of fractures seen in the study. Only smoking seemed to have a real effect on the risk. Current or past smokers and who regularly took a proton pump inhibitors had a 51% increased risk for fracture, compared to 6% in nonsmokers.

The study was presented last month by Dr. Hamed Khalili of Massachusetts General Hospital during the Digestive Disease Week conference in Chicago, Internal Medicine News said.

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