Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature.
Journal
International journal of endocrinology
ISSN: 1687-8337
Titre abrégé: Int J Endocrinol
Pays: Egypt
ID NLM: 101516376
Informations de publication
Date de publication:
2021
2021
Historique:
received:
02
04
2020
revised:
30
12
2020
accepted:
05
01
2021
entrez:
29
1
2021
pubmed:
30
1
2021
medline:
30
1
2021
Statut:
epublish
Résumé
Despite the large number of patients worldwide being on proton pump inhibitors (PPIs) for acid-related gastrointestinal disorders, uncertainty remains over their long-term safety. Particularly, the potential side effects of these drugs on bone health have been evaluated in the last years. The purpose of our narrative review is to gather and discuss results of clinical studies focusing on the interactions between PPIs and fracture risk. Data generated mainly from nested case-control studies and meta-analysis suggest that long-term/high-dose PPIs users are characterized by an increased risk of fragility fractures, mainly hip fractures. However, in these studies, the PPIs-induced bone impairment is often not adjusted for different confounding variables that could potentially affect bone health, and exposure to PPIs was reported using medical prescriptions without adherence evaluation. The mechanisms of the PPI-related bone damage are still unclear, but impaired micronutrients absorption, hypergastrinemia, and increased secretion of histamine may play a role. Clinicians should pay attention when prescribing PPIs to subjects with a preexistent high risk of fractures and consider antiosteoporotic drugs to manage this additive effect on the bone. However, further studies are needed to clarify PPIs action on the bone.
Identifiants
pubmed: 33510787
doi: 10.1155/2021/8902367
pmc: PMC7822697
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
8902367Informations de copyright
Copyright © 2021 Silvia Irina Briganti et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
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