Evidence map›Paper›PMID 25986385›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2015

Use of proton pump inhibitors is associated with fractures in young adults: a population-based study.

D E Freedberg, K Haynes, M R Denburg, B S Zemel, M B Leonard, J A Abrams, Y-X Yang

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 3 pooled it
9.2field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.

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  15. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge.Animals : an open access journal from MDPI · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

D E FreedbergDivision of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, PH-7, New York, NY, 10032, USA. def2004@cumc.columbia.edu.
K HaynesCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
M R DenburgDivision of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
B S ZemelDepartment of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
M B LeonardDepartments of Medicine and Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA.
J A AbramsDivision of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, PH-7, New York, NY, 10032, USA.
Y-X YangCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Children's Hospital of Philadelphia · USColumbia University Irving Medical Center · USUniversity of Pennsylvania · USStanford University · US

Funding

Institutional Career Development CoreKL2TR001874 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GENKINGER, JEANINE M., SHIMBO, DAICHI · 2016 to 2025
$13.6M
CTSA: K12 COMPONENTKL2RR024157 · NCRR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2006 to 2011
$8.9M
Clinical and Translational Science AwardKL2TR000081 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$3.3M
Patient Oriented Research in Vitamin D Deficiency in CKDK24DK076808 · NIDDK · STANFORD UNIVERSITY · PI LEONARD, MARY BETH · 2007 to 2016
$1.7M
Vitamin D Deficiency in Glomerular DiseaseK23DK093556 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI DENBURG, MICHELLE · 2012 to 2016
$858k
NCATS NIH HHS KL2 TR000081NCATS NIH HHS KL2 TR001874NCATS NIH HHS NIH KL2TR000081NCRR NIH HHS KL2 RR024157NIDDK NIH HHS K23 DK093556NIDDK NIH HHS K24 DK076808NIDDK NIH HHS K24DK076808
6 · The paper itself

Abstract

unlabelledProton pump inhibitors (PPIs) are associated with risk for fracture in osteoporotic adults. In this population-based study, we found a significant association between PPIs and fracture in young adults, with evidence of a dose-response effect. Young adults who use PPIs should be cautioned regarding risk for fracture.

introductionProton pump inhibitors (PPIs) are associated with fracture in adults with osteoporosis. Because PPI therapy may interfere with bone accrual and attainment of peak bone mineral density, we studied the association between use of PPIs and fracture in children and young adults.

methodsWe conducted a population-based, case-control study nested within records from general medical practices from 1994 to 2013. Participants were 4-29 years old with ≥ 1 year of follow-up who lacked chronic conditions associated with use of long-term acid suppression. Cases of fracture were defined as the first incident fracture at any site. Using incidence density sampling, cases were matched with up to five controls by age, sex, medical practice, and start of follow-up. PPI exposure was defined as 180 or more cumulative doses of PPIs. Conditional logistic regression was used to estimate the odds ratio and confidence interval for use of PPIs and fracture.

resultsWe identified 124,799 cases and 605,643 controls. The adjusted odds ratio for the risk of fracture associated with PPI exposure was 1.13 (95% CI 0.92 to 1.39) among children aged < 18 years old and 1.39 (95% CI 1.26 to 1.53) among young adults aged 18-29 years old. In young adults but not children, we observed a dose-response effect with increased total exposure to PPIs (p for trend <0.001).

conclusionsPPI use was associated with fracture in young adults, but overall evidence did not support a PPI-fracture relationship in children. Young adults who use PPIs should be cautioned regarding potentially increased risk for fracture, even if they lack traditional fracture risk factors.

Indexed as

AdolescentAdultAge FactorsCase-Control StudiesChildChild, PreschoolDose-Response Relationship, DrugDrug Administration ScheduleFemaleHistamine H2 AntagonistsHumansMaleOsteoporotic FracturesProton Pump InhibitorsUnited KingdomYoung AdultHistamine H2 AntagonistsProton Pump InhibitorsAcid suppression medicationsBone mineral densityFractureHistamine-2 receptor antagonistsOsteoporosisOutcomes researchPediatricsPharmacoepidemiologyProton pump inhibitors

Identifiers

PMID25986385
PMCPMC4575851
OpenAlexW1849496697

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.