[Proton pump inhibitors and their effect on the bone]

The proton pump inhibitors are commonly used drugs for the treatment of the digestive disorders. Many patients require long-term maintenance therapy. The prolonged acid inhibition is considered to be safe, but recently, the attention has been paid to the possible effects on the bone metabolism and the higher incidence of the fractures in patients using the PPIs.The aim of this work is to give a complex overview on the topic and analyse the source of information about the increased risk of the fractures.

Several epidemiological studies describe the incidence of the fractures in the patients with PPIs. Further articles, mainly describing the effect of the bisphosphonate therapy for the osteoporosis, also track the PPI effects. The studies dealing with the articles on densitometry targeting on the effect of the PPIs on the bone metabolism are rare.

It is not possible to unequivocally determinate the risks of the long term PPI therapy on bone based on the existing studies due to the heterogenous populations, multimorbidity of the patients and the concurrent medication. Untill now, no study has evaluated the incidence of the risk events based on the indication of the long-term therapy. Routine monitoring of the bone parameters during the PPI therapy is not recommended. The safety of the long-term PPI therapy should be based on the clear indication of the prescription.