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Proton pump inhibitors therapy and risk of hip fracture: a systematic review and meta-analysis

Ye, Xiaofeia,*; Liu, Hongb,*; Wu, Chenga,*; Qin, Yingyia; Zang, Jiajiea; Gao, Qingbina; Zhang, Xinjia; He, Jiaa

European Journal of Gastroenterology & Hepatology: September 2011 - Volume 23 - Issue 9 - p 794–800
doi: 10.1097/MEG.0b013e328348a56a
Original Articles: Oesophago-gastric Disorders

Background and aims Previous studies have reported inconsistent findings that proton pump inhibitors (PPIs) therapy might increase the risk of hip fracture. We investigated the association between PPIs therapy and hip fracture by a systematic review and meta-analysis.

Methods We systematically searched PubMed, EMBASE, and the Cochrane Library. We included studies assessing the effects of PPIs on hip fracture. Data from the studies about odds ratio and 95% confidence interval were gathered and summarized.

Results Seven studies met the inclusion criteria. PPIs therapy was associated with a statistically significant increase of hip fracture risk (pooled odds ratio=1.24; 95% confidence interval: 1.15–1.34; P<0.00001) under a random model. Meanwhile, we found that the effect of PPIs on hip fracture differs in different duration groups.

Conclusion These results indicate that PPIs therapy might have the potential risk of hip fracture. Different effects on hip fracture in the subgroup analysis do not support a causal relationship between PPIs and hip fracture. Whether the risk exists warrants further investigation.

aDepartment of Health Statistics

bInformation Center, Second Military Medical University, Shanghai, China

*Xiaofei Ye, Hong Liu, and Cheng Wu contributed equally to the writing of this article

Correspondence to Jia He, PhD, Department of Health Statistics, Second Military Medical University, Shanghai 200433, China Tel/fax: +86 21 81871441; fax: +86 21 81871441; e-mail:

Received March 7, 2011

Accepted May 8, 2011

© 2011 Lippincott Williams & Wilkins, Inc.