A new analysis adds to growing evidence that people using proton pump inhibitors to control symptoms of acid reflux are more likely to fracture bones than those who do not. The drugs are sold by prescription and over-the-counter; brand names include Prevacid, Prilosec and Nexium. Last year, the Food and Drug Administration revised the label on these drugs, known as PPIs, to warn that they may raise the risk of fractures. In March, it removed the warnings from nonprescription PPIs, saying those were meant only for short courses of treatment while the fracture risk had been observed in long-term users. The new analysis, published in Annals of Family Medicine, examined 11 studies and found that patients taking PPIs were 29 percent more likely to get fractures. The researchers also found that long-term users were 30 percent more likely to get fractures, and those taking high doses were 53 percent more likely to get hip fractures in particular. Dr. Seung-Kwon Myung, a staff physician and senior scientist at the National Cancer Center in Seoul, South Korea, and one of the paper's authors, said PPI treatment may affect the intestine's ability to absorb calcium. "Long-term or frequent use of PPIs should be avoided," he said.
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