Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature
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 purpos...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2021/8902367 |
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| author | Silvia Irina Briganti Anda Mihaela Naciu Gaia Tabacco Roberto Cesareo Nicola Napoli Pierpaolo Trimboli Marco Castellana Silvia Manfrini Andrea Palermo |
| author_facet | Silvia Irina Briganti Anda Mihaela Naciu Gaia Tabacco Roberto Cesareo Nicola Napoli Pierpaolo Trimboli Marco Castellana Silvia Manfrini Andrea Palermo |
| author_sort | Silvia Irina Briganti |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-900905476b89447b92d617efa25dccd3 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-900905476b89447b92d617efa25dccd32025-02-03T05:52:57ZengWileyInternational Journal of Endocrinology1687-83371687-83452021-01-01202110.1155/2021/89023678902367Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the LiteratureSilvia Irina Briganti0Anda Mihaela Naciu1Gaia Tabacco2Roberto Cesareo3Nicola Napoli4Pierpaolo Trimboli5Marco Castellana6Silvia Manfrini7Andrea Palermo8Unit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyUnit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyUnit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyUnit of Metabolic Diseases, Department of Internal Medicine, S. Maria Goretti Hospital, 04100 Latina, ItalyUnit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyScienza Biomediche, Università Della Svizzera Italiana (USI), Lugano, SwitzerlandPopulation Health Unit, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, ItalyUnit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyUnit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, ItalyDespite 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.http://dx.doi.org/10.1155/2021/8902367 |
| spellingShingle | Silvia Irina Briganti Anda Mihaela Naciu Gaia Tabacco Roberto Cesareo Nicola Napoli Pierpaolo Trimboli Marco Castellana Silvia Manfrini Andrea Palermo Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature International Journal of Endocrinology |
| title | Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature |
| title_full | Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature |
| title_fullStr | Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature |
| title_full_unstemmed | Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature |
| title_short | Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature |
| title_sort | proton pump inhibitors and fractures in adults a critical appraisal and review of the literature |
| url | http://dx.doi.org/10.1155/2021/8902367 |
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