SynthesisThe American journal of medicine2011
Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies.
Synthesis in The American journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02558049 (Should I Continue Taking My Acid Reflux Medication? Development and Pilot Testing of a Patient Decision Aid), which is not on this map. Cited by 124 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Should I Continue Taking My Acid Reflux Medication? Development and Pilot Testing of a Patient Decision Aid
Who cites it
124 citing papers in PubMed, 10 syntheses or guidelines pooled it, 298 citations in OpenAlex.
- Comparative efficiency and safety of potassium competitive acid blockersFrontiers in pharmacology · 2023Pooled it
- Pooled it
- Does the use of proton pump inhibitors increase the risk of hypomagnesemia: An updated systematic review and meta-analysis.Medicine · 2019Pooled it
- Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials.The lancet. Gastroenterology & hepatology · 2018Pooled it
- Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis.Digestive diseases and sciences · 2017Pooled it
- Medical versus surgical treatment for refractory or recurrent peptic ulcer.The Cochrane database of systematic reviews · 2016Pooled it
- Proton-pump inhibitors and risk of fractures: an update meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Evidence-based assessment of proton-pump inhibitors in Helicobacter pylori eradication: a systematic review.World journal of gastroenterology · 2014Pooled it
- Nonsteroidal anti-inflammatory drugs, gastroprotection, and benefit-risk.Pain practice : the official journal of World Institute of Pain · 2014Pooled it
- Comparing the Efficacy and Safety of Fexuprazan and Lansoprazole for the Prevention of Nonsteroidal Anti-inflammatory Drug-Induced Peptic Ulcer.Gut and liver · 2025Trial
- Vonoprazan prevents low-dose aspirin-associated ulcer recurrence: randomised phase 3 study.Gut · 2018Trial
- Randomized study of lafutidine vs lansoprazole in patients with mild gastroesophageal reflux disease.World journal of gastroenterology · 2016Trial
- Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler (MUSE™) for gastroesophageal reflux disease: 6-month results from a multi-center prospective trial.Surgical endoscopy · 2015Trial
- Proton pump inhibitors and hospitalization with hypomagnesemia: a population-based case-control study.PLoS medicine · 2014Trial
- Safety and efficacy of long-term esomeprazole 20 mg in Japanese patients with a history of peptic ulcer receiving daily non-steroidal anti-inflammatory drugs.BMC gastroenterology · 2013Trial
- From depression to bone health: examining the skeletal effects of classical and rapid-acting antidepressants.The international journal of neuropsychopharmacology · 2026Review
- Evolving landscape of potassium-competitive acid blockers: toward disease-specific use beyond acid suppression.Journal of gastroenterology · 2026Review
- Prescribing patterns and determinants of long-term proton pump inhibitor use in Malaysian public hospitals.Journal of Taibah University Medical Sciences · 2026Article
- Review
64 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundConcerns have been raised about the risk of fractures with acid-suppressive medications, such as proton pump inhibitors and histamine(2)-receptor antagonists.
methodsThis meta-analysis evaluated the association between proton pump inhibitor or histamine(2)-receptor antagonist use and fractures. We performed a systematic search of published literature (1970 to October 10, 2010) in MEDLINE, EMBASE, and other sources. Ten publications reporting 11 studies were considered eligible for analysis.
resultsAll studies were observational case-control or cohort studies and primarily evaluated older adults. The summary effect estimate for risk of hip fracture increased modestly among individuals taking proton pump inhibitors (relative risk [RR] 1.30, 95% confidence interval [CI], 1.19-1.43). There also was an increase in spine (RR 1.56, 95% CI, 1.31-1.85) and any-site fractures (RR 1.16, 95% CI, 1.04-1.30) among proton pump inhibitor users. These findings were similar in both men and women and after stratification by duration of use. In contrast, histamine(2)-receptor antagonist use was not significantly associated with increased risk of hip fracture (RR 1.12, 95% CI, 0.97-1.30).
conclusionIn this meta-analysis of observational studies, proton pump inhibitors modestly increased the risk of hip, spine, and any-site fractures, whereas histamine(2)-receptor antagonists were not associated with fracture risk. The possibility of residual confounding cannot be excluded. Further skeletal evaluation should be considered for patients who are taking proton pump inhibitors and also at risk for osteoporotic fracture.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.