Authors: D E Freedberg K Haynes M R Denburg B S Zemel M B Leonard J A Abrams YX Yang
Publish Date: 2015/05/19
Volume: 26, Issue: 10, Pages: 2501-2507
Abstract
Proton pump inhibitors PPIs are associated with risk for fracture in osteoporotic adults In this populationbased study we found a significant association between PPIs and fracture in young adults with evidence of a dose–response effect Young adults who use PPIs should be cautioned regarding risk for fractureProton pump inhibitors PPIs are associated with fracture in adults with osteoporosis Because PPI therapy may interfere with bone accrual and attainment of peak bone mineral density we studied the association between use of PPIs and fracture in children and young adultsWe conducted a populationbased case–control study nested within records from general medical practices from 1994 to 2013 Participants were 4–29 years old with ≥1 year of followup who lacked chronic conditions associated with use of longterm acid suppression Cases of fracture were defined as the first incident fracture at any site Using incidence density sampling cases were matched with up to five controls by age sex medical practice and start of followup PPI exposure was defined as 180 or more cumulative doses of PPIs Conditional logistic regression was used to estimate the odds ratio and confidence interval for use of PPIs and fractureWe identified 124799 cases and 605643 controls The adjusted odds ratio for the risk of fracture associated with PPI exposure was 113 95 CI 092 to 139 among children aged 18 years old and 139 95 CI 126 to 153 among young adults aged 18–29 years old In young adults but not children we observed a dose–response effect with increased total exposure to PPIs p for trend 0001PPI use was associated with fracture in young adults but overall evidence did not support a PPI–fracture relationship in children Young adults who use PPIs should be cautioned regarding potentially increased risk for fracture even if they lack traditional fracture risk factorsDaniel Freedberg was funded by the National Center for Advancing Translational Sciences NIH KL2TR000081 Michelle Denburg was funded by the NIH K23 DK093556 and a Nephcure Foundation–American Society of Nephrology Research Grant Mary Leonard was funded by the NIH K24DK076808 The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or other organizations
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