Given the fact that some large epidemiological studies have suggested an increase in PPI osteoporotic fractures, while others have not, a team of researchers led by Shelly L. Gray at the University of Washington School of Pharmacy in Seattle examined data from the Women's Health Initiative in an attempt to delve deeper into the subject.
Analyzing data from 161,806 women in the 50-79 age demographic, researchers found that women who took PPIs were more likely than others to have osteoporosis or a history of fractures, obesity, treated diabetes or a history of several health conditions. They were also less likely to take other medications chronically and had better self-reported health and physical function.
According to the researchers, once the data were adjusted to account for potential confounding factors, PPI side effects were not found to be related to hip fracture risk—nor was there found to be any relationship with the duration of PPI use.
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Two percent of the study subjects were taking omeprazole or lansoprazole at baseline. . "We did our best to adjust for these baseline differences, but, like all observational studies, residual or unmeasured confounding could explain increased associations for some fracture types," Dr. Gray said.
Dr. Mitchell H. Katz of the San Francisco Department of Health noted that the increase in non-hip fractures was 'modest,' but that the use of proton pump inhibitors was so widespread that such modest increases "add up to a lot of morbidity on a population level."
The Women's Health Initiative is a large study of an ethnically diverse cohort of postmenopausal women followed at 40 US medical centers, for a mean of 7.8 years.