Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved

Thong, Benjamin Ka Seng; Ima-Nirwana, Soelaiman; Chin, Kok-Yong

doi:10.3390/ijerph16091571

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Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved

Benjamin Ka Seng Thong

Soelaiman Ima-Nirwana

and

Kok-Yong Chin

Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2019, 16(9), 1571; https://doi.org/10.3390/ijerph16091571

Received: 5 March 2019 / Revised: 25 April 2019 / Accepted: 30 April 2019 / Published: 5 May 2019

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Abstract

The number of patients with gastroesophageal problems taking proton pump inhibitors (PPIs) is increasing. Several studies suggested a possible association between PPIs and fracture risk, especially hip fractures, but the relationship remains contentious. This review aimed to investigate the longitudinal studies published in the last five years on the relationship between PPIs and fracture risk. The mechanism underlying this relationship was also explored. Overall, PPIs were positively associated with elevated fracture risk in multiple studies (n = 14), although some studies reported no significant relationship (n = 4). Increased gastrin production and hypochlorhydria are the two main mechanisms that affect bone remodeling, mineral absorption, and muscle strength, contributing to increased fracture risk among PPI users. As a conclusion, there is a potential relationship between PPIs and fracture risks. Therefore, patients on long-term PPI treatment should pay attention to bone health status and consider prophylaxis to decrease fracture risk. View Full-Text

Keywords: bone; compression; omeprazole; osteoporosis; pantoprazole

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Thong, B.K.S.; Ima-Nirwana, S.; Chin, K.-Y. Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved. Int. J. Environ. Res. Public Health 2019, 16, 1571. https://doi.org/10.3390/ijerph16091571

AMA Style

Thong BKS, Ima-Nirwana S, Chin K-Y. Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved. International Journal of Environmental Research and Public Health. 2019; 16(9):1571. https://doi.org/10.3390/ijerph16091571

Chicago/Turabian Style

Thong, Benjamin Ka Seng, Soelaiman Ima-Nirwana, and Kok-Yong Chin. 2019. "Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved" International Journal of Environmental Research and Public Health 16, no. 9: 1571. https://doi.org/10.3390/ijerph16091571

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Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved

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