Use of Proton Pump Inhibitors Increased the Risk of Hip Fracture: a Population-based Case-control Study

Purpose: To investigate whether the use of proton pump inhibitor (PPIs) was associated with an increased risk of hip fracture.

Methods: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National health Insurance Research Database. Cases included all patients with a newly diagnosed of hip fracture in 2005 and 2006 (n = 1241). The controls were pair matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by using multiple logistic regression.

Results: Having been prescribed more than 28 defined daily dose (DDDs) of PPIs was associated with an increased risk for hip fracture in multivariate analyses (adjustments for matching variables and medication use) (at 29-70 DDDs, OR = 1.67, 95% CI = 1.11-2.51 and at >70 DDDs, OR = 2.51, 95% CI = 1.77-3.55). There was a significant trend toward increasing hip fracture risk with increasing cumulative DDDs of PPIs (p for trend <0.0001).

Conclusions: This study provides evidence that PPIs use is associated with an increased risk of hip fracture in a dose-response manner.