Study finds no evidence linking PPIs to fractures

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Proton pump inhibitors (PPI) have been inconsistently associated with osteoporotic fractures, but the authors of a new study say they found no evidence of such a link.

The study, published in Alimentary Pharmacology & Therapeutics, included 521 patients with Barrett’s oesophagus, a patient group which, the authors pointed out, represents a unique population for studying the association between PPI use and osteoporosis-related fractures, due to the use of long-term and high-dose acid suppressive therapy.

Independent risk factors for osteoporotic fractures included older age, female gender, and greater co-morbidities. The study found the incidence of all fractures and osteoporotic fractures was comparable to that of an age- and gender-matched population. More than 18 per cent of patients in the cohort were diagnosed with low bone mass after receiving a diagnosis of Barrett’s oesophagus, and 8.8 per cent suffered an osteoporotic fracture. PPI use was not associated with a statistically significant risk for developing an osteoporotic fracture at any site. 

The authors concluded that while fractures, both osteoporotic and from any aetiology, are not uncommon in subjects with Barrett’s oesophagus, "their incidence is not increased when compared to that of the general population".