Osseous implications of proton pump inhibitor therapy: An umbrella review

Bibliographic Details
Title: Osseous implications of proton pump inhibitor therapy: An umbrella review
Authors: Abdullah S. Alanazi, Hadiah Almutairi, Jeetendra Kumar Gupta, Dibyalochan Mohanty, Deepankar Rath, Ali A. AlOdan, Ahmed Mahal, Mahalaqua Nazli Khatib, Shilpa Gaidhane, Quazi Syed Zahiruddin, Sarvesh Rustagi, Prakasini Satapathy, Hashem Abu Serhan
Source: Bone Reports, Vol 20, Iss , Pp 101741- (2024)
Publisher Information: Elsevier, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the musculoskeletal system
Subject Terms: Proton pump inhibitors, Bone health, Fracture risk, Bone mineral density, Meta-analysis, Diseases of the musculoskeletal system, RC925-935
More Details: Background: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide for acid-related disorders. While their short-term efficacy and safety are well-established, concerns regarding their long-term effects on bone health have emerged. This umbrella review aimed to synthesize the available findings on the associations between PPI use and bone metabolism outcomes. Methods: An electronic search was conducted using PubMed, Web of Science, Embase, and the Cochrane Database up to September 16, 2023. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) and observational studies that evaluated the relationship between PPIs and bone metabolism outcomes were included. Data extraction, quality appraisal, and synthesis were performed in line with the Joanna Briggs Institute and PRISMA guidelines. The strength of the evidence was graded using the GRADE criteria. Statistical analysis was performed in R version 4.3. Results: Out of 299 records, 27 studies met the inclusion criteria. The evidence indicated a statistically significant increased risk of fractures, notably hip, spine, and wrist fractures, in PPI users. PPI use was associated with changes in Bone Mineral Density (BMD) across various bones, though the clinical relevance of these changes remains uncertain. Furthermore, PPI-induced hypomagnesemia, which can influence bone health, was identified. A notable finding was the increased risk of dental implant failures in PPI users. However, the certainty of most of the evidence ranged from very low to low based on GRADE criteria. Conclusion: The long-term use of PPIs may be associated with adverse bone health outcomes, including increased fracture risk, alterations in BMD, hypomagnesemia, and dental implant failure. While these findings highlight potential concerns for long-term PPI users, the current evidence's low certainty underscores the need for robust, high-quality research to clarify these associations.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2352-1872
Relation: http://www.sciencedirect.com/science/article/pii/S2352187224000081; https://doaj.org/toc/2352-1872
DOI: 10.1016/j.bonr.2024.101741
Access URL: https://doaj.org/article/3fb13b59d8b645f6b40e988d9a592725
Accession Number: edsdoj.3fb13b59d8b645f6b40e988d9a592725
Database: Directory of Open Access Journals
More Details
ISSN:23521872
DOI:10.1016/j.bonr.2024.101741
Published in:Bone Reports
Language:English