[Proton pump inhibitors and their effect on the bone]

Area of Science:

• Gastroenterology
• Pharmacology
• Bone Metabolism

Background:

• Proton pump inhibitors (PPIs) are frequently prescribed for digestive disorders, often requiring long-term use.
• While generally considered safe, prolonged acid inhibition by PPIs has raised concerns about potential impacts on bone metabolism and fracture incidence.
• This review synthesizes current knowledge on the relationship between PPI use and fracture risk.

Purpose of the Study:

• To provide a comprehensive overview of the existing literature on PPIs and fracture risk.
• To analyze the sources of information regarding the potential increased risk of fractures associated with PPI therapy.
• To evaluate the current evidence on the effects of long-term PPI use on bone health.

Main Methods:

• Review of epidemiological studies investigating fracture incidence in PPI users.
• Analysis of articles examining the effects of bisphosphonate therapy and concurrent PPI use.
• Identification of studies focusing on bone densitometry and PPI effects on bone metabolism.

Main Results:

• Multiple epidemiological studies report on fracture incidence in patients using PPIs.
• Some studies on osteoporosis treatments, like bisphosphonates, also assess PPI effects.
• Research specifically investigating PPIs' impact on bone metabolism through densitometry is limited.

Conclusions:

• Existing studies have heterogeneous populations, comorbidities, and concurrent medications, preventing definitive conclusions on long-term PPI risks to bone.
• No study has yet evaluated fracture risk based on the specific indication for long-term PPI therapy.
• Routine monitoring of bone parameters during PPI therapy is not recommended; safety relies on clear prescription indications.