Objective: Recent studies suggested an increased risk of fractures with interaction between bisphosphonates (BPs) and proton pump inhibitors (PPIs). We performed a meta-analysis of fractures between patients taking BPs/PPIs and those taking BPs only.
Methods: We conducted a PubMed database and Ovid database search, as well as Cochrane Library search (up to July 2014) for studies assessing the association between fractures and BPs or/and PPIs. We performed random effects meta-analysis of odds ratios (OR) according to fracture type and conducted subgroup analyses by race and BP subtypes. Heterogeneity was assessed using Q statistics and I(2) statistic.
Results: After study selection, 4 unique studies (5 comparisons) including 57259 patients were available for this meta-analysis. Pooled analysis of overall fracture risk of BP+PPI group versus BP group showed a significant increase in risk of fractures (OR = 1.52, P = 0.025), with substantial heterogeneity. However, heterogeneity was drastically reduced in subgroup of Asian (I(2) = 24% and P = 0.251), and fracture risk showed a significant increase (OR = 1.75, P = 0.026). In contrast, heterogeneity was little eliminated in subgroup of European, and fracture risk was no statistical difference (OR = 1.42, P = 0.068). Three studies including 4 comparisons reported on spine fracture were included in the pooled analysis demonstrating an increased spine fracture risk associated with BP/PPI interaction (OR = 1.60, 95% CI 1.13-2.26, P = 0.008, I(2) = 58.6%).
Conclusions: This meta-analysis suggests that there is an interaction associated with increased fracture risk (particularly for spine and Asian race) between BP and PPI use. Clinicians should carefully evaluate such risk factors for osteoporosis in patients taking BPs, before routinely prescribing PPIs, and make a careful judgment as to whether PPIs may be safe for patients at high risk of fractures.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483859 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Musculoskeletal adverse events associated with CDK4/6 inhibitors: a real-world study using FDA Adverse Event Reporting System (FAERS) database.
BMC Pharmacol Toxicol
January 2025
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Objective: Cyclin-dependent kinase (CDK)-4/6 inhibitors have significantly improved outcomes in several cancers but can also induce various organ system toxicities, including musculoskeletal disorders. This study aimed to comprehensively characterize the musculoskeletal adverse events (MSAEs) associated with CDK4/6 inhibitors based on real-world data.
Methods: Reports of MSAEs linked to CDK4/6 inhibitors from the first quarter (Q1) of 2015 and 2023 Q4 were extracted from the FAERS.
Bioelectronic osteosynthesis plate to monitor the fracture bone healing using electric capacitive variations.
J Orthop Surg Res
January 2025
Department of Mechanical Engineering, Centre for Mechanical Technology & Automation (TEMA), University of Aveiro, Aveiro, 3810-193, Portugal.
Background: Bone fractures represent a global public health issue. Over the past few decades, a sustained increase in the number of incidents and prevalent cases have been reported, as well as in the years lived with disability. Current monitoring techniques predominantly rely on imaging methods, which can result in subjective assessments, and expose patients to unnecessary cumulative doses of radiation.
View Article and Find Full Text PDFCan monolithic zirconia frameworks in implant-supported cross-arch prostheses deliver reliable long-term outcomes?
Evid Based Dent
January 2025
Eastman Dental Institute, London, UK.
Design: A retrospective cohort study assessing the mid-to-long-term outcomes and risk factors affecting the prosthetic success and survival of implant-supported cross-arch fixed dental prostheses (IFCDPs) with monolithic zirconia frameworks.
Cohort Selection: Forty-seven patients received a total of 51 cross-arch prostheses (27 maxillary and 24 mandibular prostheses), supported by 302 implants. Comprehensive clinical and radiographic records were available over a follow-up period ranging from 5 to 13 years.
Bioprosthetic valve fracture for transcatheter aortic valve-in-valve replacement: A systematic literature review.
Ann Thorac Surg
January 2025
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
Transcatheter aortic valve-in-valve replacement presents a viable, minimally invasive approach to replacing degraded bioprosthetic surgical valves. The major drawback of this technique is poor hemodynamics in the form of patient-prosthesis mismatch and high transvalvular gradients. This is commonly attributable to the reduced valvular diameter from the transcatheter heart valve fixed inside the degraded bioprosthesis.
View Article and Find Full Text PDFImproved Risk Adjustment for Comorbid Diagnoses in Administrative Claims Analyses of Orthopaedic Surgery.
J Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Stanford University, Redwood City, California.
Background: The accurate inclusion of patient comorbidities ensures appropriate risk adjustment in clinical or health services research and payment models. Orthopaedic studies often use only the comorbidities included at the index inpatient admission when quantifying patient risk. The goal of this study was to assess improvements in capture rates and in model fit and discriminatory power when using additional data and best practices for comorbidity capture.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!