Association between proton pump inhibitors use and risk of hip fracture: A general population-based cohort study.
アブストラクト Previous studies comparing risk of fracture among Proton Pump Inhibitors (PPIs) users with that among non-users were susceptible to confounding by indication. Epidemiologic studies of this association using an active medication as a comparator would appropriately address this bias. We conducted a propensity-score matched cohort study to compare the risk of incident fracture over five years among initiators of PPIs with initiators of histamine 2 receptor antagonist (H2RA) using data collected from The Health Improvement Network (THIN) database in the United Kingdom (2000-2016). The prevalence of PPIs prescription increased 3.8-fold from 2000 (7.9%) to 2012 (30.3%) and remained stable since then. Of the 50,265 propensity-score matched participants in each cohort (mean age was 65 years, and 57% were women), 370 (1.9/1000 person-years) incident hip fracture occurred in the PPIs initiators and 294 (1.5/1000 person-years) in the H2RA initiators during the follow-up period. The rate difference of incident hip fracture for PPIs initiation was 0.4 (95% confidence interval [CI]: 0.2-0.7)/1000 person-years compared with H2RA initiation and the corresponding hazard ratio (HR) was 1.27 (95%CI: 1.09-1.48). Compared with non-PPI use, multivariable-adjusted odds ratios (ORs) of hip fracture were 1.17 (95%CI: 0.94-1.46), 1.55 (95%CI: 1.23-1.96), and 1.67 (95%CI: 1.33-2.10) for 1-2, 3-9 and >/= 10 prescriptions of PPIs, respectively (P for trend = 0.001). We found that PPIs prescription has been increasing rapidly over the past decade in the United Kingdom, and the initiation of PPIs was associated with a higher risk of hip fracture than initiation of H2RA. ジャーナル名 Bone 投稿日 2020/7/1 投稿者 Wei, Jie; Chan, Andrew T; Zeng, Chao; Bai, Xiaochun; Lu, Na; Lei, Guanghua; Zhang, Yuqing 組織名 Health Management Center, Xiangya Hospital, Central South University, Changsha,;Hunan, China; Division of Rheumatology, Allergy, and Immunology, Department of;Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA,;USA.;Division of Gastroenterology, Department of Medicine, Massachusetts General;Hospital, Harvard Medical School, Boston, MA, USA; Clinical and Translational;Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School,;Boston, MA, USA; Department of Immunology and Infectious Diseases, Harvard T. H.;Chan School of Public Health, Harvard Medical School, Boston, MA, USA.;Division of Rheumatology, Allergy, and Immunology, Department of Medicine,;Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;;Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha,;Hunan, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha,;Hunan, China.;Department of Orthopedics, Academy of Orthopedics Guangdong Province, Orthopedic;Hospital of Guangdong Province, Guangdong Provincial Key Laboratory of Bone and;Joint Degenerative Diseases, The Third Affiliated Hospital of Southern Medical;University, Guangzhou, China; Department of Cell Biology, Key Laboratory of;Mental Health of the Ministry of Education, School of Basic Medical Sciences,;Southern Medical University, Guangzhou, China.;Arthritis Research Canada, Richmond, Canada.;Hunan, China; National Clinical Research Center of Geriatric Disorders, Xiangya;Hospital, Central South University, Changsha, Hunan, China. Electronic address:;email@example.com.;Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.;Electronic address: firstname.lastname@example.org. Pubmed リンク https://www.ncbi.nlm.nih.gov/pubmed/32593677/