Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies

Poly, Tahmina Nasrin; Islam, Mohaimenul; Yang, Hsuan-Chia; Wu, Chih Chiang; Li, Y.-C. .

doi:10.1007/s00198-018-4788-y

Cited by 116 publications

(83 citation statements)

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“…We performed a systematic review of the literature according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses based on the Cochrane systematic review and meta-analysis guidelines. We have previously used this method in several published reviews [17][18][19].…”

Section: Methodsmentioning

confidence: 99%

Association between Use of Statin and Risk of Dementia: A Meta-Analysis of Observational Studies

et al. 2019

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Background and Aims: The impact of statin on dementia risk reduction has been a subject of debate over the last decade, but the evidence remains inconclusive. Therefore, we performed a meta-analysis of relevant observational studies to quantify the magnitude of the association between statin therapy and the risk of dementia. Methods: We systematically searched for relevant studies published from January 2000 to March 2018 using EMBASE, Google, Google Scholar, PubMed, Scopus, and Web of Science. Two authors performed study selection, data abstraction, and risk of bias assessment. We then extracted data from the selected studies and performed meta-analysis of observational studies using a random-effects model. Subgroup and sensitivity analyses were also conducted. Results: A total of 30 observational studies, including 9,162,509 participants (84,101 dementia patients), met the eligibility criteria. Patients with statin had a lower all-caused dementia risk than those without statin (risk ratio [RR] 0.83, 95% CI 0.79-0.87, I 2 = 57.73%). The over-all pooled reduction of Alzheimer disease in patients with statin use was RR 0.69 (95% CI 0.60-0.80, p < 0.0001), and the overall pooled RR of statin use and vascular dementia risk was RR 0.93 (95% CI 0.74-1.16, p = 0.54). Conclusion: This study suggests that the use of statin is significantly associated with a decreased risk of dementia. Future studies measuring such outcomes would provide useful information to patients, clinicians, and policymakers. Until further evidence is established, clinicians need to make sure that statin use should remain restricted to the treatment of cardiovascular disease.

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Section: Methodsmentioning

confidence: 99%

Association between Use of Statin and Risk of Dementia: A Meta-Analysis of Observational Studies

et al. 2019

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“…Nevertheless, the list of potential side-effects related to long-term PPI use is increasing, including among others, chronic kidney disease, osteoporosis and fractures, Clostridium difficile infections, community acquired pneumonia, cardiac diseases, and even increased mortality [8][9][10][11][12][13][14][15][16][17][18][19]. An increasing number of studies have also investigated the risk of cancer with most evidence existing for gastric, colorectal and pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

Long-term proton pump inhibitor usage and the association with pancreatic cancer in Sweden

2019

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Background The long-term safety of proton pump inhibitors (PPIs) is increasingly questioned. The aim of our study was to assess the risk of pancreatic cancer among longterm PPI users in Sweden. Methods This population-based nationwide Swedish cohort study including 796,492 adult long-term PPI users has been used to calculate the standardized incidence rate ratios (SIRs) and 95% confidence intervals (CI) for pancreatic cancer, stratifying by indications of use, age, sex, and duration of use. The risk among all 20,210 long-term H2-receptor antagonist users was assessed as comparison.Results Pancreatic cancer was found in 1733 long-term PPI users, and 25 H2-receptor antagonist users. For PPI users, the risk of pancreatic cancer was increased overall (SIRs = 2.22; 95% CI 2.12-2.32) and in all subgroup analyses, with the highest risk among PPI-users younger than 40 years (SIR = 8.90,, and among individuals with a history of Helicobacter pylori (SIR = 2.99, 95% CI 2.54-3.49). After the first year after enrolment (during which PPI use may be because of early symptoms of pancreatic cancer), the risk remained increased over time, with SIR = 1.57 (95% CI 1.38-1.76) after 5 years. No associations were found for H2-receptor antagonists (SIR = 1.02, 95% CI 0.66-1.51). Conclusions This large study showed an increased risk of pancreatic cancer in long-term users of PPIs in Sweden, in particular among the youngest users.

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“…This systematic review and meta-analysis assessed the risk of hip fractures in people using PPIs 1. It is the largest meta-analysis on this topic to date, with pooled data from 24 observational studies in North America, Europe and Asia that involved a total of 2 103 800 participants.…”

Section: Overviewmentioning

confidence: 99%

“…Several meta-analyses of observational studies have also highlighted an association between PPI use and bone fracture 1 2. In 2012, the Medicines and Healthcare products Regulatory Agency (MHRA) issued a warning about the risk of hip, wrist or spine fracture, especially where PPIs are used in high doses and for longer than 1 year 3.…”

Section: Contextmentioning

confidence: 99%

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More data on the association between PPIs and fracture risk

2020

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Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies

Cited by 116 publications

References 50 publications

Association between Use of Statin and Risk of Dementia: A Meta-Analysis of Observational Studies

Association between Use of Statin and Risk of Dementia: A Meta-Analysis of Observational Studies

Long-term proton pump inhibitor usage and the association with pancreatic cancer in Sweden

More data on the association between PPIs and fracture risk

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