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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

More PPI fracture data

The Canadian Medical Association Journal has published the results of a retrospective analysis of the Population Health Research Data Repository that aimed to further explore the relation between duration of exposure to proton pump inhibitors (PPIs) and osteoporosis-related fractures.

The study matched 15,792 cases of fracture for age, gender and co-morbidities with 47,289 controls. The study did not appear to correct for different doses of PPIs but analysed the data in terms of duration of exposure.

A statistically significant increase in hip fractures was detected as 5 years exposure (adjusted OR 1.62, 95% CI 1.02–2.58) and for all osteoporosis-related fractures (hip, vertebra or wrist) after 7 years exposure (adjusted OR 1.92, 95% CI 1.16–3.18).

These results are consistent with other similar analyses. An editorial accompanying this paper notes that this is the third large studies of administrative databases that has found an association between hip fractures and usage of PPIs. It also calls for further prospective research to be conducted to confirm these findings.

Action: As previously suggested, clinicians should ensure patients are made aware of the potential risks and make effective use of step-down, step-off and when required treatment strategies to minimise drug exposure.

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