- A large meta-analysis finds that use of proton pump inhibitors (PPIs) may increase the risk for hip fracture by 20%.
- Higher, sustained doses are associated with the greatest risk.
Why this matters
- Largest meta-analysis to date confirms and extends an earlier meta-analysis.
- Findings suggest that clinicians should be cautious about long-term PPI therapy in patients with already higher risk for hip fracture.
- Meta-analysis of 24 observational studies (15 case-control; 9 cohort) involving 2,103,800 participants, of whom 319,568 had hip fractures.
- Selected studies (must be n≥500 with ≥1 year follow-up) were obtained from MEDLINE, EMBASE, Google Scholar, and Web of Science.
- Funding: Ministry of Education, Taiwan; Health and Welfare surcharge of tobacco grants.
- Use of PPIs (vs nonuse) was associated with a higher risk for hip fracture (risk ratio [RR], 1.20; P<.0001>
- The association increased with the highest doses:
- Low dose: RR, 1.17 (P=.002).
- Medium dose: RR, 1.29 (P<.0001>
- High dose: RR, 1.30 (P<.0001>
- ≥3 years of use: RR, 1.24 (P<.0001>
- Observational designs.
- No randomized controlled studies.
- Not enough information on sex, age, smoking status, alcohol use.