Proton-pump inhibitors and risk of fractures: an update meta-analysis
Summary To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture. Introduction Many studie...
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description | Summary
To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture.
Introduction
Many studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies.
Methods
A systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses.
Results
Eighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (
p
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doi_str_mv | 10.1007/s00198-015-3365-x |
format | Article |
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To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture.
Introduction
Many studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies.
Methods
A systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses.
Results
Eighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (
p
< 0.001;
I
2
= 71.9 %). After limiting to cohort studies, there was also a moderate increase in hip fracture risk without evidence of study heterogeneity. Pooling revealed that short-term use (<1 year) and longer use (>1 year) were similarly associated with increased risk of hip fracture. Furthermore, a moderately increased risk of spine (RR = 1.58, 95 % CI 1.38–1.82) and any-site fracture (RR = 1.33, 95 % CI 1.15–1.54) was also found among PPI users.
Conclusion
In this update meta-analysis of observational studies, PPI use modestly increased the risk of hip, spine, and any-site fracture, but no evidence of duration effect in subgroup analysis.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-015-3365-x</identifier><identifier>PMID: 26462494</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Endocrinology ; Fractures ; Hip Fractures - chemically induced ; Humans ; Inhibitor drugs ; Medicine ; Medicine & Public Health ; Meta-analysis ; Observational Studies as Topic ; Original Article ; Orthopedics ; Osteoporosis ; Osteoporotic Fractures - chemically induced ; Proton Pump Inhibitors - adverse effects ; Rheumatology ; Risk Assessment - methods ; Risk factors ; Side effects ; Spinal Fractures - chemically induced</subject><ispartof>Osteoporosis international, 2016-01, Vol.27 (1), p.339-347</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2015</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-a1d16c8a7ba4a562fa66c40e5b0e033f4e8ad7991ae24e4e6d82e9636f4f05363</citedby><cites>FETCH-LOGICAL-c541t-a1d16c8a7ba4a562fa66c40e5b0e033f4e8ad7991ae24e4e6d82e9636f4f05363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-015-3365-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-015-3365-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26462494$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, B.</creatorcontrib><creatorcontrib>Huang, Y.</creatorcontrib><creatorcontrib>Li, H.</creatorcontrib><creatorcontrib>Sun, W.</creatorcontrib><creatorcontrib>Liu, J.</creatorcontrib><title>Proton-pump inhibitors and risk of fractures: an update meta-analysis</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture.
Introduction
Many studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies.
Methods
A systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses.
Results
Eighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (
p
< 0.001;
I
2
= 71.9 %). After limiting to cohort studies, there was also a moderate increase in hip fracture risk without evidence of study heterogeneity. Pooling revealed that short-term use (<1 year) and longer use (>1 year) were similarly associated with increased risk of hip fracture. Furthermore, a moderately increased risk of spine (RR = 1.58, 95 % CI 1.38–1.82) and any-site fracture (RR = 1.33, 95 % CI 1.15–1.54) was also found among PPI users.
Conclusion
In this update meta-analysis of observational studies, PPI use modestly increased the risk of hip, spine, and any-site fracture, but no evidence of duration effect in subgroup analysis.</description><subject>Endocrinology</subject><subject>Fractures</subject><subject>Hip Fractures - chemically induced</subject><subject>Humans</subject><subject>Inhibitor drugs</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Observational Studies as Topic</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Osteoporotic Fractures - chemically induced</subject><subject>Proton Pump Inhibitors - adverse effects</subject><subject>Rheumatology</subject><subject>Risk Assessment - methods</subject><subject>Risk factors</subject><subject>Side effects</subject><subject>Spinal Fractures - chemically induced</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUtLxDAUhYMozjj6A9xIwY2baN5t3MkwPmBAFwruQtrease-TFqY-fdmqIoIgqtA8p1z7s1B6JiSc0pIfOEJoTrBhErMuZJ4vYOmVHCOmVZyF02J5jHWgj5P0IH3KxI0Wsf7aMKUUExoMUWLB9f2bYO7oe6isnkt07JvnY9sk0eu9G9RW0SFs1k_OPCX4Toautz2ENXQW2wbW2186Q_RXmErD0ef5ww9XS8e57d4eX9zN79a4kwK2mNLc6qyxMapFVYqVlilMkFApgQI54WAxOZhRGqBCRCg8oSBVlwVoiCSKz5DZ6Nv59r3AXxv6tJnUFW2gXbwhsaJJoJwQf-BKqkTrkPuDJ3-Qlft4MJqgUqYljIRlAWKjlTmWu8dFKZzZW3dxlBitnWYsQ4T6jDbOsw6aE4-nYe0hvxb8fX_AWAj4MNT8wLuR_Sfrh9NfpSM</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Zhou, B.</creator><creator>Huang, Y.</creator><creator>Li, H.</creator><creator>Sun, W.</creator><creator>Liu, J.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Proton-pump inhibitors and risk of fractures: an update meta-analysis</title><author>Zhou, B. ; Huang, Y. ; Li, H. ; Sun, W. ; Liu, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-a1d16c8a7ba4a562fa66c40e5b0e033f4e8ad7991ae24e4e6d82e9636f4f05363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Endocrinology</topic><topic>Fractures</topic><topic>Hip Fractures - chemically induced</topic><topic>Humans</topic><topic>Inhibitor drugs</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Observational Studies as Topic</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Osteoporotic Fractures - chemically induced</topic><topic>Proton Pump Inhibitors - adverse effects</topic><topic>Rheumatology</topic><topic>Risk Assessment - methods</topic><topic>Risk factors</topic><topic>Side effects</topic><topic>Spinal Fractures - chemically induced</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, B.</creatorcontrib><creatorcontrib>Huang, Y.</creatorcontrib><creatorcontrib>Li, H.</creatorcontrib><creatorcontrib>Sun, W.</creatorcontrib><creatorcontrib>Liu, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, B.</au><au>Huang, Y.</au><au>Li, H.</au><au>Sun, W.</au><au>Liu, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proton-pump inhibitors and risk of fractures: an update meta-analysis</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>27</volume><issue>1</issue><spage>339</spage><epage>347</epage><pages>339-347</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture.
Introduction
Many studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies.
Methods
A systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses.
Results
Eighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (
p
< 0.001;
I
2
= 71.9 %). After limiting to cohort studies, there was also a moderate increase in hip fracture risk without evidence of study heterogeneity. Pooling revealed that short-term use (<1 year) and longer use (>1 year) were similarly associated with increased risk of hip fracture. Furthermore, a moderately increased risk of spine (RR = 1.58, 95 % CI 1.38–1.82) and any-site fracture (RR = 1.33, 95 % CI 1.15–1.54) was also found among PPI users.
Conclusion
In this update meta-analysis of observational studies, PPI use modestly increased the risk of hip, spine, and any-site fracture, but no evidence of duration effect in subgroup analysis.</abstract><cop>London</cop><pub>Springer London</pub><pmid>26462494</pmid><doi>10.1007/s00198-015-3365-x</doi><tpages>9</tpages></addata></record> |
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subjects | Endocrinology Fractures Hip Fractures - chemically induced Humans Inhibitor drugs Medicine Medicine & Public Health Meta-analysis Observational Studies as Topic Original Article Orthopedics Osteoporosis Osteoporotic Fractures - chemically induced Proton Pump Inhibitors - adverse effects Rheumatology Risk Assessment - methods Risk factors Side effects Spinal Fractures - chemically induced |
title | Proton-pump inhibitors and risk of fractures: an update meta-analysis |
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