TY - JOUR
T1 - The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women
T2 - A prospective cohort study
AU - van der Hoorn, Mariëlle M. C.
AU - Tett, Susan E.
AU - de Vries, Oscar J.
AU - Dobson, Annette J.
AU - Peeters, Geeske M.E.E.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Objectives: Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. Methods: Data were included from 4432 participants (born 1921-26) in the 2002 survey of the Australian Longitudinal Study on Women's Health. Medication data were from the national pharmaceutical administrative database (2003-2012, inclusive). Fractures were sourced from linked hospital datasets available for four major States of Australia. Competing risk regression models used PPI exposure as a time-dependent covariate and either time to first osteoporosis medication prescription or fracture as the outcome, with death as a competing risk. Results: Of the 2328 PPI users and 2104 PPI non-users, 827 (36%) and 550 (26%) became users of osteoporosis medication, respectively. PPI use was associated with an increased risk of subsequent use of osteoporosis medication (adjusted sub-hazard ratio [SHR] = 1.28; 95% confidence interval [CI] = 1.13-1.44) and subsequent fracture (SHR = 1.29, CI = 1.08-1.55). Analysis with PPI categorized according to defined daily dose (DDD), showed some evidence for a dose-response effect (osteoporosis medication:
AB - Objectives: Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. Methods: Data were included from 4432 participants (born 1921-26) in the 2002 survey of the Australian Longitudinal Study on Women's Health. Medication data were from the national pharmaceutical administrative database (2003-2012, inclusive). Fractures were sourced from linked hospital datasets available for four major States of Australia. Competing risk regression models used PPI exposure as a time-dependent covariate and either time to first osteoporosis medication prescription or fracture as the outcome, with death as a competing risk. Results: Of the 2328 PPI users and 2104 PPI non-users, 827 (36%) and 550 (26%) became users of osteoporosis medication, respectively. PPI use was associated with an increased risk of subsequent use of osteoporosis medication (adjusted sub-hazard ratio [SHR] = 1.28; 95% confidence interval [CI] = 1.13-1.44) and subsequent fracture (SHR = 1.29, CI = 1.08-1.55). Analysis with PPI categorized according to defined daily dose (DDD), showed some evidence for a dose-response effect (osteoporosis medication:
KW - Esomeprazole
KW - Fractures
KW - Omeprazole
KW - Osteoporosis medication
KW - Proton pump inhibitors
UR - http://www.scopus.com/inward/record.url?scp=84943605631&partnerID=8YFLogxK
U2 - 10.1016/j.bone.2015.08.024
DO - 10.1016/j.bone.2015.08.024
M3 - Article
AN - SCOPUS:84943605631
VL - 81
SP - 675
EP - 682
JO - Bone
JF - Bone
SN - 8756-3282
ER -