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Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies

Cited 77 time in Web of Science Cited 91 time in Scopus
Authors
Eom, Chun-Sick; Park, Sang Min; Myung, Seung-Kwon; Yun, Jae Moon; Ahn, Jeong-Soo
Issue Date
2011-05
Publisher
Annals of Family Medicine
Citation
ANNALS OF FAMILY MEDICINE Vol.9 No.3, pp. 257-267
Keywords
복합학
Abstract
PURPOSE Previous studies have reported inconsistent findings regarding the association between the use of acid-suppressive drugs such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H(2)RAs) and fracture risk. We investigated this association using meta-analysis.METHODS We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library from inception through December 2010 using common key words. We included case-control, nested case-control, and cohort studies. Two evaluators independently reviewed and selected articles. We determined pooled effect estimates by using random-effects meta-analysis, because of heterogeneity.RESULTS Of 1,809 articles meeting our initial inclusion criteria, 5 case-control studies, 3 nested case-control studies, and 3 cohort studies were included in the final analyses. The pooled odds ratio (OR) for fracture was 1.29 (95% confidence interval [Cl], 1.18-1.41) with use of PPIs and 1.10 (95% Cl, 0.99-1.23) with use of H(2)RAs when compared with nonuse of the respective medications. Long-term use of PPIs increased the risk of any fracture (adjusted OR = 1.30; 95% Cl, 1.15-1.48) and hip fracture risk (adjusted OR = 1.34; 95% Cl, 1.09-1.66), whereas long-term H(2)RA use was not significantly associated with fracture risk.CONCLUSIONS We found possible evidence linking PPI use to an increased risk of fracture, but no association between H(2)RA use and fracture risk. Widespread use of PPIs with the potential risk of fracture is of great importance to public health. Clinicians should carefully consider their decision to prescribe PPIs for patients already having an elevated risk of fracture because of age or other factors.
ISSN
1544-1709
Language
English
URI
http://hdl.handle.net/10371/81820
DOI
https://doi.org/10.1370/afm.1243
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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