Heartburn :: Heartburn drugs leads to fractures, hip fractures

Long-term use of popular anti-heartburn drugs like Nexium, Prevacid and Prilosec that decreases stomach acid production increases the risk of hip fractures in adults over 50, perhaps because the drugs inhibit calcium absorption, researchers said.

Use of the drugs proton pump inhibitors (PPIs) for the treatment of acid-related diseases such as gastro esophageal reflux disease (GERD) is associated with a greater risk of hip fracture, according to a study in the December 27 issue of JAMA.

Yu-Xiao Yang, M.D., M.S.C.E., of the University of Pennsylvania School of Medicine, Philadelphia, conducted a study to determine what effects PPI therapy has on bone metabolism and hip fracture risk in a large group representative of the general population. The researchers analyzed data from the General Practice Research Database (1987-2003), which contains information on patients in the United Kingdom. The study group consisted of users of PPI therapy and nonusers of acid suppression drugs who were older than 50 years.

In summary, we observed that PPI therapy is associated with a significantly increased risk of hip fractures, with the highest risk seen among those receiving high-dose PPI therapy. Osteoporotic fractures are common among the elderly population, and they entail considerable morbidity and mortality. On the other hand, PPI therapy is widespread and may have an exaggerated effect among those at risk for osteoporosis. Thus, further studies are urgently needed to confirm our findings and clarify the underlying mechanism, said Yang, “For elderly patients who require long-term and particularly high-dose PPI therapy, it may be prudent to reemphasize increased calcium intake, preferably from a dairy source, and co-ingestion of a meal when taking insoluble calcium supplements.”

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