A meta-analysis of previous research into an unintended effect of popular acid suppression medications - some of the most widely used medications in the world - finds evidence that long-term use of proton pump inhibitors, but not H2-receptor antagonists, is associated with increased risk of bone fracture. The meta-analysis of 11 studies finds that PPIs are associated with a 29 percent increase of fracture, including 31 percent increased risk of hip fracture and a 54 percent increased risk of vertebral fractures. Long-term H2RA use, by contrast, was not significantly associated with fracture risk. With acid-suppressive drugs representing the second leading medication worldwide, these findings are of great importance to public health. The authors conclude clinicians should carefully consider their decision to prescribe PPIs for patients, especially those who already have an elevated risk of fracture because of age or other factors.
An accompanying editorial puts the study findings into context. The editorialists conclude the study findings reinforce the need for balancing risks and benefits of any therapy physicians prescribe. Because long-term PPI exposure may lead to other unwanted effects, they should be reserved for patients likely to benefit from them and should be prescribed at the lowest effective maintenance dose (Courtesy of EurekAlert!, a service of AAAS).