Study Finds PPIs up Fracture Risk by 30 Percent

A new study has found a link between the popular heart burn drugs known as <"">proton pump inhibitors (PPIs) and an increased risk of fractures. The study, which is published in the Annals of Family Medicine, concluded that PPIs could increase the likelihood of fractures by as much as 30 percent.

PPIs work by reducing the amount of acid in the stomach, and are approved to treat conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. Prescription versions of the drugs include Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, and Aciphex. OTC brands include Prilosec OTC, Zegerid OTC and Prevacid 24HR.

This new study, which was conducted by researchers at Seoul National University Hospital in South Korea, analyzed 11 earlier studies that looked into the link between fracture risk and PPIs. They found that the risk of fracture increases by 29 percent with the use of PPIs, with hip fracture risk rising by 31 percent, and the risk for vertebral fractures by 54 percent.

At the same time, the researchers did not see any substantial increase between the use of H2-receptor antagonist, another class of heart burn drugs, and fractures.

It is surmised that PPIs may increase fracture risks because they inhibit the ability of the body to absorb calcium, which leads to weaker bones, the study authors wrote.

Last year, the U.S. Food & Drug Administration (FDA) said it would be adding information about the potential fracture risk to the label of PPIs. This came after a review of several epidemiological studies reported an increased risk of fractures of the hip, wrist, and spine with PPI use. Some studies found that those at greatest risk for these fractures received high doses of proton pump inhibitors or used them for one year or more. The majority of the studies evaluated individuals 50 years of age or older and the increased risk of fracture primarily was observed in this age group, the agency said

While the FDA’s decision originally applied to both over-the-counter and prescription PPIs, the agency announced earlier this year that it would not go forward with plans to update the labels of over-the-counters. According to the FDA, a review had “concluded that fracture risk with short-term, low dose PPI use is unlikely.”

Earlier this month, the first lawsuit was filed against AstraZeneca over an increased risk of bone fractures allegedly caused by the proton pump inhibitor Nexium. As we reported previously, plaintiff Ginny Begin, 58, claims she suffered “severe bone deterioration” and a number of fractures after taking Nexium daily from 2003 to 2011. Her lawsuit was filed in U.S. District Court in Texas.

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