The Effect of Proton Pump Inhibitors on Bone Mineralisation A Systematic Review with Focus on PHOSPHO1

Proton pump inhibitors (PPIs) are among the most widely prescribed drugs for long-term suppression of gastric acid. Though generally considered safe, increasing evidence links their use to altered bone metabolism. This systematic review investigates the hypothesis that PPI-induced inhibition on PHOSPHO1-a bone-specific phosphatase- impairs bone mineralisation.

A systematic electronic search was conducted for experimental studies from January 2000 to January 2025. The screening and selection followed PRISMA guidelines.

Of 20 articles identified, 3 met the inclusion criteria: two in-vitro studies and one combining both in-vitro and in-vivo data. All three examined the effects of PPIs on bone formation and consistently reported significantly reduced minerallization capacity.

The review suggests that PPIs appear to inhibit PHOSPHO1 activity, potentially impairing early-stage bone mineralisation. However, due to the limited number of studies, these findings should be interpreted with caution, and further research is warranted.