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PROTON PUMP INHIBITORS AND THE RISK OF OSTEOPOROSIS RELATED FRACTURES
LE Targownik, LM Lix, CJ Metge, HJ Prior, S Leung, WD Leslie
INTRODUCTION: The use of proton pump inhibitors has been associated with an increased risk of hip fracture. We sought to further explore the relationship between duration of PPI use and osteoporosis-related fractures, defined as fractures of the hip, vertebra, and wrist.
METHODS: We used administrative claims data from Manitoba, Canada to identify all cases of fractures of the hip, vertebra, or wrist occurring between 1996-2004, who were each matched with 3 controls on age, sex, and medical comorbidity. Odds ratios for the risk of hip fracture and all osteoporosis-related fracture were calculated for durations of PPI exposure ranging from more than one to more than seven years.
RESULTS: 15792 cases of osteoporosis related fracture were matched with 47289 controls. We did not detect a significant association between osteoporosis related fracture and durations of PPI use for PPI exposures for durations of 4 years or less. However, duration of PPI exposure exceeding 5 years and greater were associated with increased odds of osteoporosis-related fractures (OR >5 years: 1.27, >6 years: 1.47, >7 years; 2.42, all p-values < 0.05). (Figure 1).
CONCLUSIONS: Duration of PPI exposure exceeding five years is associated with a significantly increased risk of osteoporosis-related fracture. Further study is required to determine the clinical significance of this finding at to determine the value of osteoprotective medications in long-term PPI users.
