慢性使用欧美普拉对老年人骨质疏松性骨折率的不同影响
Rachel Gingold-Belfer1,2, Yichayaou Beloosesky3,2, Amir Amara3,2
1Gastroenterology Division, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
British journal of clinical pharmacology
|July 18, 2023
概括
在老年人中,慢性用欧美普拉与骨质疏松性骨折 (OF) 风险增加无关. 这项大型研究没有发现任何独立的关联,这表明目前的质子抑制剂指南对老年人骨健康是安全的.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 像奥梅普拉这样的质子抑制剂 (PPI) 广泛用于与酸有关的疾病.
- 人们担心PPI的潜在长期不良影响,包括骨健康.
- 骨质疏松性骨折 (OF) 在老年人群中构成重大健康负担.
研究的目的:
- 评估慢性梅使用与骨质疏松性骨折发生率之间的关联.
- 为了确定欧梅普拉是否是社区居住的老年人骨折的独立风险因素.
主要方法:
- 这是一项追溯的队列研究,从2002年至2016年,对超过46,000名65岁以上的社区居住的以色列人进行了追溯研究.
- 关于人口统计,骨折史和奥梅普拉处方 (>11/年) 的数据是从电子医疗记录中提取的.
- 使用多变量Cox比例危险回归模型来分析骨质疏松性骨折的风险.
主要成果:
- 在14年的随访期间,骨质疏松性骨折发生在4.0%的慢性奥梅普拉使用者中,而非使用者中为2.8%.
- 初步分析显示,使用欧梅普拉的OF风险增加了16% (年龄/性别调整).
- 经过对OF已知的风险因素进行调整后,慢性梅的使用并不是一个独立的风险因素 (aHR=0.965). 在85岁以上的人群中观察到反向相关性.
结论:
- 长期使用欧美普拉与老年人骨质疏松性骨折风险的增加无关.
- 这些发现支持在老年人中继续使用欧美普拉,而不会增加骨折问题.
- 进一步的研究可能会探索在老年人群中观察到的逆相关性.
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