MedWire News: Stomach acid-suppressing drugs called proton pump inhibitors and histamine-2 receptor antagonists are effective for the treatment of patients with gastro-oesophageal reflux disease and other digestive disorders, but they may be associated with an increased risk of hip fractures, say researchers.
A number of previous studies have suggested that stomach acid suppressing drugs may increase the risk of fractures, but others have found no such association, explained lead researcher Dr Douglas Corley, from Kaiser Permanente in San Francisco, California, USA.
To investigate further, Dr Corley and team studied data from the Northern California Kaiser Permanente integrated health-services organisation on 33,752 patients who suffered hip fractures and 130,471 similar patients who did not.
They assessed the patients’ use of proton pump inhibitors and histamine-2 receptor antagonists as well as confounding factors such as smoking, alcohol use and use of other medications.
The researchers found that patients who had suffered hip fractures were 30% more likely to have used proton pump inhibitors for at least 2 years and 18% more likely to have used histamine-2 receptor antagonists for at least 2 years than the other patients.
Overall, higher doses and longer durations of stomach acid-suppressing treatment were associated with corresponding increases in fracture risk. Indeed, compared with patients who had never taken stomach acid suppressing drugs, those who had taken more than one pill a day for at least 2 years had a 41% increased risk of fractures, those who had taken one pill a day for at least 2 years had a 30% increased risk and those who had taken less than one pill a day had a 12% increased risk.
The team also noted an increased risk of hip fractures among patients who had used stomach acid-suppressing drugs for shorter periods of time.
“Although we cannot exclude persistent confounding, the increased risk with short-term use of acid suppressing drugs suggests that even relatively brief periods of use may be associated with increased risk of hip fractures,” said Dr Corley.
Speaking at Digestive Disease Week 2009 in Chicago, Illinois, USA, he concluded: “Patients taking acid suppressors should continue treatment at the lowest effective dose. However, they should discuss treatment options with their doctor if they are at risk of osteoporosis.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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