Table 8.
Key studies demonstrating AST use and its side effects associated with bone and joints
| Study | Study characteristic | Key findings |
|---|---|---|
| Corsonello et al.120 | Prospective observational study N = 401 older adults discharged from acute care hospitals | PPI use was associated with a decline in basic activities of daily living over a 12-month follow-up |
| Zhou et al.121 | Meta-analysis of 18 observational studies N = 2,44,109 fracture cases | PPI users had a 26% higher risk of hip fractures, 58% higher risk of spine fractures, and 33% higher risk of fractures at any other site |
| Thaler et al.122 | Cross-sectional study N = 400 female patients hospitalized after fall | PPI use was associated with an increased risk of recurrent falls (OR, 1.92, p = 0.04) and fractures (OR, 2.15, p = 0.03) |
| Poly et al.118 | Meta-analysis of 24 observational studies N => 2 million participants | PPI users reported a significantly higher risk of hip fractures compared with nonusers (RR, 1.20; p < 0.0001) |
| Park et al.123 | Nested case-control study N = 3,50,000 patients with GERD and PUD | The risk of osteoporotic fractures increased with prolonged PPI use (p < 0.001) PPI users had a higher risk of osteoporotic fracture than H2RA users (OR, 1.37) |
| Chou et al.124 | Population-based retrospective cohort study N = 3,98,885 T2DM patients | T2DM patients on long-term PPI therapy were at greater risk of developing hip fractures (HR, 1.41) Also, patients on low-dose PPIs were associated with an increased risk of fractures |
| Ursomanno et al.125 | Retrospective study N = 635 patients with dental implants, n = 1,480 implant sites | PPI users showed more (79.80% increase) crestal implant bone loss compared with nonusers |
| Bruin et al.126 | Case-cohort study | PPI users were associated with a 2.4-fold higher risk of developing prosthetic joint infection compared with nonusers, in patients undergoing THA |
| da Maia et al.127 | Systematic review and meta-analysis | Menopausal women on PPI therapy had a significantly greater risk for fractures (RR, 1.93; p < 0.0001) |
| Klifto et al.128 | Post-hoc comparative analysis N = 281 DRF patients | A cohort of PPI users had a significantly higher incidence of median nerve injuries (12 vs 3%; p = 0.025) and radial shaft fractures (5 vs 0%; p = 0.020) compared with nonusers |
DRF, distal radius fractures; GERD, gastroesophageal reflux disease; PPI, proton pump inhibitor; PUD, peptic ulcer disease; RR, risk ratio; THA, total hip arthroplasty