Long‐term proton pump inhibitor use and risk of osteoporosis and hip fractures: A nationwide population‐based and multicenter cohort study using a common data model. Issue 8 (11th May 2022)

• Record Type: Journal Article
• Authors: Park, Da Hee; Seo, Seung In; Lee, Kyung Joo; Kim, Jinseob; Kim, Yerim; Seo, Won‐Woo; Lee, Hyung Seok; Shin, Woon Geon; Yoo, Jong Jin
• Other Names: Mahadeva Sanjiv guestEditor.; Chiu Han‐Mo guestEditor.; Wu Chun‐Ying guestEditor.; Lui Rashid guestEditor.
• Is Part Of: Journal of gastroenterology and hepatology. Volume 37:Issue 8(2022)
• Page Start: 1534
• Page End: 1543
• Publication Date: 2022-05-11
• Subjects: common data model -- hip fracture -- osteoporosis -- proton pump inhibitor; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.15879
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Association between protonpump inhibitors (PPIs) and osteoporosis, hip fractures has not been fully elucidated. We aimed to evaluate the relationship between PPIs use and the risk of osteoporosis and hip fractures in the databases converted to a common data model (CDM) and to compare the results across the databases. Methods: This was a population‐based, propensity‐matched, retrospective cohort study that included patients aged ≥ 50 years who were prescribed with PPIs for over 180 days. We compared the incidence of osteoporosis and hip fractures between new PPI user and new user of other drugs using the Cox proportional hazards model and performed meta‐analysis in the electronic health record (EHR) databases. Results: In the Korean National Health Insurance Service (NHIS)–CDM database, long‐term PPI users had greater risk of osteoporosis [PPIs vs non‐PPIs groups, 28.42/1000 person‐years vs 19.29/1000 person‐years; hazard ratio (HR), 1.62; 95% confidence interval (CI), 1.22–2.15; P = 0.001]. The meta‐analytic results of six EHR databases also showed similar result (pooled HR, 1.57; 95% CI, 1.28–1.92). In the analysis of hip fracture, PPI use was not significantly associated with a hip fracture in the NHIS–CDM database (PPI vs non‐PPI groups, 3.09/1000 person‐years vs 2.26/1000 person‐years; HR, 1.45; 95% CI, 0.74–2.80; P = 0.27). However, in the meta‐analysis of four EHR databases, the risk of hip fractures was higher in PPI users (pooled HR, 1.82; 95% CI, 1.04–3.19). Conclusions: Long‐term PPI was significantly associated with osteoporosis; however, the results of hip fractures were inconsistent. Further study based on better data quality may be needed.